Selective Serotonin Reuptake Inhibitors

Zoloft, Prozac, Effexor, Pristiq and other SSRIs

Sep 23, 2009 Michael McGrath

Selective serotonin reuptake inhibitors are antidepressants that act on the brain's serotonin levels. Learn more about SSRIs.

Selective serotonin reuptake inhibitors, or SSRIs, are second generation depression medication available only by prescription. Less likely to cause serious side effects than older tricyclic antidepressants and monoamine oxidase inhibitors (MAOI antidepressants), SSRIs are usually the first antidepressants prescribed to people coping with depression.

How SSRIs Work

SSRIs affect levels of the neurotransmitter serotonin. Serotonin is a chemical compound released by nerve cells that helps the cells transmit information from one cell to another. Low levels of serotonin and other neurotransmitters may cause symptoms of depression and anxiety disorders.

Selective serotonin reuptake inhibitors prevent nerve cells from reabsorbing the serotonin they release. This provides the brain with more serotonin and helps maintain adequate levels of the neurotransmitter.

Common SSRIs

SSRIs are usually prescribed as tablets or capsules, although some SSRIs are also available as an oral solution. Not all SSRIs are effective for all people – some people have to try several antidepressants before they find one that works well without producing unwanted side effects.

Selective serotonin reuptake inhibitors include:

Celexa (citalopram)
Lexapro (escitalopram oxalate)
Luvox (fluvoxamine)
Paxil (paroxetine)
Pristiq (desvenlafaxine)
Prozac (fluoxetine)
Zoloft (sertraline).

All SSRIs take time to work. After a week or two of use many people experience some relief from depression symptoms, but SSRIs need to be taken for six to eight weeks before their full effect is felt.

SSRI Antidepressant Side Effects

Not all SSRIs work for all people, and some people develop unwanted side-effects from the medication. Each brand of SSRI has its own list of possible side-effects, but the following problems are possible with any selective serotonin reuptake inhibitor:

diarrhea
dizziness
drowsiness
headaches
increased anxiety
irritability
loss of appetite
loss of libido (sexual desire)
kidney or liver problems
nausea
photosensitivity (increased sensitivity to sunlight)
skin rashes
sleep disturbances
weight gain
worsening depression symptoms.

The U.S. Food and Drug Administration requires a suicide advisory on all antidepressants, including SSRIs. Some people experience suicidal behavior as a side effect of antidepressants. In most cases the benefits offered by selective serotonin reuptake inhibitors outweigh the risk of possible suicidal behavior. Still, when starting any new antidepressant people should be monitored for possible suicidal behavior.

When to Avoid Selective Serotonin Reuptake Inhibitors

People should not take selective serotonin reuptake inhibitors if they are allergic to SSRIs, and care should be taken if previous SSRI use has worsened depression symptoms or resulted in suicidal behavior.

Women who are pregnant or plan to get pregnancy should talk to their doctors before using selective serotonin reuptake inhibitors. Two SSRIs – Paxil and Paxil CR – have been linked to birth defects.

SSRIs are not appropriate treatment for all types of depression. Selective serotonin reuptake inhibitors can cause manic episodes in people with bipolar disorder, for instance. When an SSRI is used to treat bipolar disorder, it may need to be prescribed with a mood stabilizer.

Alcohol can interfere with the benefits of selective serotonin reuptake inhibitors, while SSRIs intensify the effects of alcohol. People taking SSRIs should avoid consuming alcohol.

SSRIs and Serotonin Syndrome

Combining certain medication with SSRIs increases the risk of serotonin syndrome, a potentially fatal condition caused by excessive serotonin levels. Medications that may cause serotonin syndrome when combined with SSRIs include tricyclic antidepressants, MAOI antidepressants and triptan migraine medications, amongst others. The dietary supplement St. John’s Wort, when taken with antidepressants, has also been linked to serotonin syndrome.

People prescribed SSRIs should provide the prescribing doctor with a complete list of medications they take, including over the counter medication, prescriptions and dietary supplements.

SSRIs and Antidepressant Withdrawal

Patients should continue to take selective serotonin reuptake inhibitors until advised otherwise by their doctor. Although SSRIs are not considered addictive, suddenly halting SSRI treatment can result in a number of unpleasant side effects, including dizziness, headaches, and anxiety.

The risk of a relapse into depression symptoms is increased if SSRIs are stopped suddenly. In most cases, treatment with selective serotonin reuptake inhibitors ends by slowly tapering off the daily dosage over the course of several weeks.

Resources

eMedicine Health. (Retrieved 19 September, 2009). SSRIs and Depression

WebMD. (Retrieved 19 September, 2009). Selective serotonin reuptake inhibitors (SSRIs) for Depression

Disclaimer: The information contained within this article is for informational purposes only, and is not intended to be a substitute in any way for care and treatment by a qualified health professional.

The copyright of the article Selective Serotonin Reuptake Inhibitors in General Medicine is owned by Michael McGrath. Permission to republish Selective Serotonin Reuptake Inhibitors in print or online must be granted by the author in writing.

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SSRIs can Cause Birth Defects	Avoid Alcohol When Taking SSRIs