Q15

What is the difference between multimodal and monomodal?

Answered by Bernhard Baune

The pharmacological difference between monomodal and multimodal drug action is based on the number of different modes of action involved. For example, when a drug acts as a reuptake inhibitor only (regardless of the monoamine blocked) then this is a single mode of action and defined as a monomodal drug. In contrast, when more than one mode of action is involved (e.g. reuptake inhibition and receptor activity as pharmacological targets) then this is defined as multimodal drug action (see Figure 1). It appears that combining multiple modes of monoaminergic action may enhance the efficacy of antidepressant treatment for some patients.

Figure 1: Monomodal and multimodal antidepressant actions on the reuptake of monoamine neurotransmitters at synapses and modulation of the reactivity of serotonin receptors on the post-synaptic dendritic membrane.

Multimodal antidepressants may have greater efficacy against depression due to their multimodal effects of reducing the reuptake of monoamines as well as decreasing their movement into the post-synaptic neuron.

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