Category: SSRI

What are SSRIs?

SSRIs, or Selective Serotonin Reuptake Inhibitors, are commonly prescribed medications for depression, anxiety, and other mental health issues. They mainly work by boosting serotonin levels in the brain, which is important for managing mood, emotions, and sleep.

How do SSRIs work?

SSRIs help keep more serotonin available in the brain by stopping its reabsorption into the nerve cells that released it. Normally, after serotonin is released, it gets taken back up by the same cells to stop its effects. By blocking this process, SSRIs let serotonin stay longer in the space between nerve cells, helping it activate the receiving receptors for a longer time.

When serotonin levels go up, it helps messages travel better between nerve cells and is thought to reduce feelings of depression and anxiety. After using SSRIs for several weeks, some changes happen in the brain, like the reduction of certain receptors that normally limit serotonin. This reduction allows more serotonin to be released, which boosts its helpful effects.

SSRI medications mainly affect serotonin and have little impact on other neurotransmitters like dopamine and norepinephrine, which helps them have fewer side effects than older antidepressants like tricyclics and monoamine oxidase inhibitors.

Common uses of SSRIs

• Major depressive disorder
• Generalised anxiety disorder
• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Post-traumatic stress disorder (PTSD)
• Social anxiety disorder
• Bulimia nervosa and other eating disorders

Common SSRI medications

• Fluoxetine (Prozac)
• Sertraline (Zoloft)
• Paroxetine (Paxil)
• Citalopram (Celexa)
• Escitalopram (Lexapro)
• Fluvoxamine (Luvox)

Possible side effects of SSRIs

SSRIs are usually safer and easier to handle than older antidepressants, but they can still cause side effects, particularly in the first few weeks of treatment. Common side effects include:

• Nausea, vomiting, or diarrhea
• Headache
• Sleep disturbances such as insomnia or drowsiness
• Dry mouth
• Nervousness, anxiety, or restlessness
• Shaking or tremors
• Sexual dysfunction, including decreased libido or difficulty achieving orgasm
• Weight changes (loss or gain)

Most side effects improve over time or with dosage adjustments.

Risks and precautions

• Sexual dysfunction is a common but troubling side effect and might require changing medication or dose adjustments.
• Increased risk of bleeding especially if combined with NSAIDs, aspirin, or blood thinners.
• Serotonin syndrome, a rare but serious condition caused by excessive serotonin, may occur with drug interactions or overdose, presenting symptoms like rapid heart rate, high fever, or confusion and requires immediate medical attention.
• Withdrawal symptoms can happen if SSRIs are stopped abruptly; gradual tapering is advised.
• Some SSRIs (e.g., citalopram) can prolong the QT interval in the heart rhythm, requiring careful use in patients with heart issues.

Important considerations

SSRIs help increase serotonin in the brain by preventing its reabsorption, which improves mood and reduces anxiety. They are often the first choice for treating various mental health issues because they work well and have manageable side effects. However, a healthcare provider should supervise therapy to ensure the best results and reduce risks.