Selective serotonin reuptake inhibitors

What are Selective serotonin reuptake inhibitors?

SSRI stands for Selective Serotonin Reuptake Inhibitor. SSRI antidepressants are a type of antidepressant that have been shown to increase levels of serotonin within the brain.

Serotonin is a neurotransmitter that is often referred to as the “feel good hormone”. It carries messages between brain cells and contributes to well-being, good mood, appetite, as well as helping to regulate the body’s sleep-wake cycle and internal clock. Historically, it was thought that depression was caused by low levels of serotonin and other neurotransmitters in the brain, although experts now do not think this is the case.

SSRIs increase levels of serotonin in the brain by preventing the reuptake of serotonin by nerves. All SSRI antidepressants have this effect.

Antidepressants relieve the symptoms of depression. SSRIs are one type of antidepressant. Other types include tricyclic antidepressants (TCAs), serotonin and norepinephrine reuptake inhibitors (SNRIs), norepinephrine and dopamine reuptake inhibitors (NDRIs), monoamine oxidase inhibitors (MAOIs), and the atypical antidepressants.

What are SSRI antidepressants used for?

SSRI antidepressants help to relieve symptoms of depression such as low mood, irritability, feelings of worthlessness, restlessness, anxiety, and difficulty in sleeping.

They are one of the most commonly prescribed antidepressants because they are effective at improving mood with fewer or less severe side effects compared to some other antidepressants.

In addition to depression, SSRIs may also be used to treat a range of other conditions, for example:

Anxiety
Bulimia nervosa
Fibromyalgia
Hot flashes
Obsessive-compulsive disorder
Panic disorder
Post-Traumatic Stress Disorder
Premenstrual dysphoric disorder

Some reduction in symptoms may be noticed within one to two weeks; however, it may take six to eight weeks of treatment before the full effects are seen.

What are the differences between SSRI antidepressants?

Although all SSRI antidepressants are thought to act in the same way, there are differences between individual SSRIs with regards to how long they remain in the body, how they are metabolized, and how much they interact with other medications. For example, fluoxetine, fluvoxamine, and paroxetine are more likely to interact with other medications than citalopram, escitalopram and sertraline.

Generic name	Brand name examples
citalopram	Celexa
escitalopram	Lexapro
fluoxetine	Prozac, Sarafem
fluvoxamine	Luvox
paroxetine	Brisdelle, Paxil, Pexeva
sertraline	Zoloft
vilazodone*	Viibryd

*Vilazodone is considered a serotonin modulator. Exactly how it works for depression is unknown but it does appear to potentiate serotonergic activity in the CNS.

Are SSRI antidepressants safe?

When taken at the recommended dosage, SSRI antidepressants are considered safe. However, they have been associated with a few serious, potentially fatal, severe side effects such as:

An increase in suicidal thoughts and behaviors, particularly in children and young adults under the age of 25 years. This is most likely to occur when starting therapy
Serotonin syndrome – this is caused by excessive levels of serotonin in the body and is more likely to occur with higher dosages of SSRIs or when SSRIs are administered with other medications that also release serotonin (such as dextromethorphan, tramadol, and St. John's Wort). Symptoms include agitation, confusion, sweating, tremors, and a rapid heart rate
An increase in the risk of bleeding, especially if used with other medications that also increase bleeding risk.

In addition, some SSRIs, such as citalopram have been associated with abnormal heart rhythms with higher dosages.

What are the side effects of SSRI antidepressants?

Not everybody experiences side effects with SSRIs antidepressants. Some of the more commonly reported side effects include:

Blurred vision
Dizziness
Drowsiness (fluoxetine is more likely to cause insomnia)
Dry mouth
Gastrointestinal upset (such as constipation, diarrhea, or nausea)
Headache
Sexual dysfunction (such as reduced desire or erectile dysfunction).

Several SSRIs have been associated with a discontinuation syndrome when they have been stopped suddenly. For this reason, it is best to withdraw all antidepressants slowly.

For a complete list of side effects, please refer to the individual drug monographs.

List drug with Selective serotonin reuptake inhibitors

Drug Name
Brisdelle Generic name: Paroxetine
Celexa Generic name: Citalopram
Citalopram Generic name: Citalopram
Escitalopram Generic name: Escitalopram
Fluoxetine Generic name: Fluoxetine
Fluvoxamine Generic name: Fluvoxamine
Lexapro Generic name: Escitalopram
Luvox Generic name: Fluvoxamine
Luvox CR Generic name: Fluvoxamine
Paroxetine Generic name: Paroxetine
Paxil Generic name: Paroxetine
Paxil CR Generic name: Paroxetine
Pexeva Generic name: Paroxetine
Prozac Generic name: Fluoxetine
Prozac Weekly Generic name: Fluoxetine
Rapiflux Generic name: Fluoxetine
Sarafem Generic name: Fluoxetine
Selfemra Generic name: Fluoxetine
Sertraline Generic name: Sertraline
Zoloft Generic name: Sertraline

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