Mechanism of action Selected drug examples
Increase serotonin release
Amphetamines, MDMA Antidepressants: mirtazapine Opioids: oxycodone, tramadol, dextromethorphan
Inhibit serotonin uptake
Amphetamines, MDMA, cocaine SSRIs: citalopram, escitalopram, fluoxetine, paroxetine, sertraline SNRIs: duloxetine, venlafaxine TCAs: amitriptyline, clomipramine, imipramine Opioids: methadone, tramadol, dextromethorphan
Inhibit serotonin metabolism
Anxiolytics: buspirone MAOI: phenelzine, rasagiline, selegiline
Activate Serotonin Receptors Inhibit Cytochrome P450 Hallucinogen: LSD Antidepressants: trazodone Opioids: fentanyl Mood stabilizers: lithium CYP2D6 Inhibitors: fluoxetine, sertraline Substrates: dextromethorphan, oxycodone, risperidone, tramadol CYP3A4 Inhibitors: ciprofloxacin, ritonavir Substrates: methadone, oxycodone, venlafaxine CYP2C19 Inhibitors: fluconazole Substrates: citalopram