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Sodium-
dependent
serotonin
transporter
5-
hydroxytryptamine
receptor 2A
5-
hydroxytryptamine
receptor 2C
Voltage-
dependent
P/Q-type
calcium channel
subunit
alpha-1A
Voltage-
dependent
L-type calcium
channel subunit
beta-1
Voltage-
dependent
calcium channel
subunit
alpha-2/delta-2
Synaptic
vesicular amine
transporter
Tryptophan
5-hydroxylase 1
Aromatic-L-
amino-acid
decarboxylase
Ca
+
Serotonin
Amitriptyline
Serotonin
Ca
+
Serotonin
Amitriptyline
Amitriptyline
L-Tryptophan
Tetrahydrobiopterin
O
2
5-Hydroxy-L-tryptophan
4a-Hydroxytetrahydrobiopterin
CO
2
Fe2+
Pyridoxal
5'-phosphate
Gq signaling
cascade
Synaptic Vesicle
Cytosol
Cytosol
Presynaptic Neuron
Postsynaptic Neuron
Synapse
Mood Improvement
Serotonin is synthesized and
stored in synaptic vesicles
at the nerve terminal
Amitriptyline inhibits the
serotonin reuptake
transporter, thereby
increasing synaptic
serotonin
Serotonin activates 5HT2A
and 5HT2C receptors, which
are responsible for mood
improvements
Blood-Brain Barrier
Diffusion
SLC6A4
HTR2A
HTR2C
CACNA1A
CACNB1
CACNA2D2
SLC18A2
TPH1
DDC
Calcium
Serotonin
Amitriptyline
Serotonin
Calcium
Serotonin
Amitriptyline
Amitriptyline
L-Tryptophan
Tetrahydrobiopterin
Oxygen
5-Hydroxy-L-
tryptophan
4a-
Hydroxytetrahydrobiopterin
Carbon dioxide
Gq signaling
cascade
SLC6A4
HTR2A
HTR2C
CACNA1A
CACNB1
CACNA2D2
SLC18A2
TPH1
DDC
Ca
+
5-HT
Amitrip
5-HT
Ca
+
5-HT
Amitrip
Amitrip
Trp
BH4
O
2
5-HTP
4aHtHbp
CO
2
Fe2+
Pyr-5'P
Gq si c
Synaptic Vesicle
Cytosol
Cytosol
Presynaptic Neuron
Postsynaptic Neuron
Synapse
Mood Improvement
Serotonin is synthesized and
stored in synaptic vesicles
at the nerve terminal
Amitriptyline inhibits the
serotonin reuptake
transporter, thereby
increasing synaptic
serotonin
Serotonin activates 5HT2A
and 5HT2C receptors, which
are responsible for mood
improvements
Blood-Brain Barrier
Diffusion