Eli5 How do Serotonin antagonist and reuptake inhibitors work?

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My doctor just put me on trazodone which I guess is a very commonly prescribed medication for insomnia depression and anxiety. I’m trying to figure out how it works but everything I read makes me feel dumber anyone have layman’s terms to explain?

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Anonymous 0 Comments

SARIs like trazodone are a bit peculiar. While on the one hand they act as serotonin *reuptake inhibitors*, making more serotonin available in the brain (and many people will just tell you “more serotonin = good”, which is vastly oversimplifying things) by slowing the rate at which it is removed, SARIs also *antagonize* (= block) the function of specific serotonin receptors. That might seem paradoxical, putting more of some molecule in the brain but then interfering with some of the ways you expect that molecule to do its job. But there are many different serotonin receptors that send different sorts of signals upon binding. The details are all terribly complicated, and incompletely understood even at the cutting edge. But the 5-HT 2A receptor that trazodone blocks is known to be more active in some depressed people, so in such cases one might benefit from interfering with this receptor specifically.

Source: wikipedia for 5-HT 2A mostly. Scientist in a different field wondering why receptor antagonism and reuptake inhibition of the same molecule is a sensible thing for a drug to do.

E: mandatory *not a doctor*, also.