Guest Author - Carissa Vaughn

What are SSRIs?

Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressants in which the main purpose is the treatment of depression, anxiety disorders, and some personality disorders.

Some SSRIs are available in extended-release form or controlled-release form, shown as the primary medication name with the letters XR, CR, or XL on the end. These forms of the medication are intended in design to provide controlled release of the medication throughout the day or for a week at a time with a single dose, although through testimonials and studies conducted it appears that the daily doses maintain better theraputic levels depending on the individual's kidney function.

Certain brain chemicals called neurotransmitters are linked with depression, including the neurotransmitter serotonin. SSRIs seem to help alleviate symptoms of depression by blocking the reabsorption (reuptake) of serotonin by certain nerve cells (presynaptic cells) in the brain. This leaves more serotonin available in the brain. As a result, this enhances neurotransmission — the sending of nerve impulses — and improves mood. SSRIs are called selective because they seem to affect only serotonin, not other neurotransmitters (such as noradrenaline and dopamine). Research intimates that abnormalities in neurotransmitter activity affect mood and behavior. Therefore, if you have too much or too little, then you may experience fluctuations in how you are feeling and general 'moodiness' throughout the day.

SSRIs approved by FDA

The SSRIs that have been approved by the Food and Drug Administration to treat depression are listed below with their generic or chemical names followed by available brand names in parentheses.

Escitalopram (Lexapro) Lexapro Website

Fluoxetine (Prozac, Prozac Weekly) Prozac Website

Sertraline (Zoloft) Zoloft Website

Citalopram (Celexa) Celexa PDF reroute

Paroxetine (Paxil, Paxil CR) Paxil CR Website

Some of these medications may also be used to treat conditions other than depression such as social anxiety and panic disorder. You may experience less nausea with controlled-release forms of SSRIs if this becomes an uncomfortable side effect for you. It is important to discuss all options in dosages and any symptoms experienced with your medical doctor or psychiatrist. It is also important that your doctor is aware of any other medications you are currently taking or if you feel an increase in depressive feelings or suicidal thoughts. While this is not common, it can happen and can be addressed by a change in medication and therapy if necessary.

SSRIs are generally considered safer than other classes of antidepressants. They're less likely to have adverse interactions with other medications, and they're less dangerous if taken as an overdose. All SSRIs have the same general mechanism of action and side effects. However, individual SSRIs have some different pharmacological qualities. That means you may respond differently to certain SSRIs or have diverse side effects with certain SSRIs. For instance, you may have unpleasant side effects with one SSRI but not another.

Side effects of SSRIs can include: nausea, increased sweating, sexual dysfunction, including reduced desire or orgasm difficulties, headache, dry mouth, dizziness, diarrhea, agitation, restlessness, weight gain, drowsiness, insomnia, nervousness, and rash. The websites of the makers of each medication listed have the full listings of side effects and treatment options. Sometimes physicians will choose to include an antianxiety agent for use in combination with antidepressents to help with the side effects and to help combat the feelings of anxiety that can accompany depression.

(Chapter) Sheldon H. Preskorn, Christina Y. Stanga, Ruth Ross, Selective serotonin reuptake inhibitor, pp. 242 in Sheldon H. Preskorn, Christina Y. Stanga, John P. Feighner, Ruth Ross (Editors) (2004), Antidepressants: Past, Present, and Future, Springer, ISBN 3540430547

Richard J. Goldberg, MD. Selective Serotonin Reuptake Inhibitors: Infrequent Medical Adverse Effects. Arch Fam Med. 1998;7:78-84.

http://www.nlm.nih.gov/medlineplus/druginformation.html