What do SSRIs do to "normal" people?
The Food and Drug Administration (FDA) has approved these SSRIs to treat depression: Citalopram (Celexa) Escitalopram (Lexapro) Fluoxetine (Prozac) Paroxetine (Paxil, Pexeva) Sertraline (Zoloft)
What should I know about SSRIs?
Jan 11, 2022 · Selective serotonin reuptake inhibitors (SSRIs) are a class of medications most commonly prescribed to treat depression. They are often used as first-line pharmacotherapy for depression and numerous other psychiatric disorders due to their safety, efficacy, and tolerability. They are approved for use in both adult and pediatric patients. [1]
Are SSRIs worth it?
Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressant medication prescribed for treatment of a range of psychiatric disorders.
What are the most common side effects of SSRIs?
Sep 05, 2014 · SSRI medications you may be familiar with include: Zoloft (sertraline) Prozac (fluoxetine) Celexa (citalopram) Lexapro (escitalopram) Paxil (paroxetine)
SSRIs Approved to Treat Depression
The Food and Drug Administration (FDA) has approved these SSRIs to treat depression: 1. Citalopram (Celexa) 2. Escitalopram (Lexapro) 3. Fluoxetine...
Possible Side Effects and Cautions
All SSRIs work in a similar way and generally can cause similar side effects, though some people may not experience any. Many side effects may go a...
Suicide Risk and Antidepressants
Most antidepressants are generally safe, but the FDA requires that all antidepressants carry black box warnings, the strictest warnings for prescri...
Stopping Treatment With SSRIs
SSRIs aren't considered addictive. However, stopping antidepressant treatment abruptly or missing several doses can cause withdrawal-like symptoms....
Finding The Right Antidepressant
People may react differently to the same antidepressant. For example, a particular drug may work better — or not as well — for you than for another...
What Are SSRIs?
SSRI is short for selective serotonin reuptake inhibitor. The SSRIs are a group of related chemical compounds that increase the amount of the neuro...
What conditions do SSRIs treat?
Although SSRIs are primarily used to treat depression, they are commonly prescribed for the treatment of anxiety and related conditions. They ha...
What are common SSRIs and their uses?
Popular SSRI antidepressants include sertraline (Zoloft), fluoxetine (Prozac, Sarafem), citalopram (Celexa), paroxetine (Paxil, Brisdelle, Pexeva),...
How are SSRIs prescribed?
In many cases, a process of trial and error is required to find an antidepressant that works and has a tolerable profile of side effects. It may...
How Do SSRIs Work?
Exactly how the SSRIs counter depression has never been clear. Despite all the books and attention that SSRIs get, the drugs fully relieve depres...
Does depression result from a chemical imbalance of the brain?
The belief that depression is a chemical imbalance caused by low serotonin levels has become widely accepted, despite there being no evidence for...
What is the rationale for using drugs that affect serotonin?
The monoamine theory of depression has long been influential. It holds that depression results from a deficit of one or more neurotransmitters in t...
What does “reuptake inhibitor” mean?
Reuptake inhibitors bond to the transporter molecules that typically chaperone neurotransmitters across the synapse. By taking up the space that th...
If depression isn’t a chemical imbalance, what is it?
Modern thinking suggests that depression is a problem of circuitry, not chemistry. In this view, symptoms of depression result from failure of syna...
How long does it take for SSRIs to work?
The effect of SSRIs may take up to 6 weeks before the patients feel the effects of treatment.[15] If patients tolerate the current dose well, the clinician can consider an increase in dosage after several weeks.
What is the effect of SSRIs on the axon?
SSRIs inhibit the serotonin transporter (SERT) at the presynaptic axon terminal. By inhibiting SERT, an increased amount of serotonin (5-hydroxytryptamine or 5HT) remains in the synaptic cleft and can stimulate postsynaptic receptors for a more extended period. [4][5][6]
What is the cause of serotonin syndrome?
It can result from overdosing on SSRIs or from combining multiple medications that increase serotonin levels . Serotonin syndrome is characterized by mental status changes, autonomic dysfunction, and dystonias. Findings may include agitation, tachycardia, hypertension, hyperthermia, hyperreflexia, tremor, nausea, vomiting, and clonus.[16] Serotonin syndrome may present similarly to neuroleptic malignant syndrome and malignant hyperthermia. This is especially important to keep in mind since commonly prescribed psychiatric medications can cause both serotonin syndrome and neuroleptic malignant syndrome. In general, serotonin syndrome is distinguishable by taking a thorough history. Serotonin syndrome also has a rapid onset and resolution. There is no definitive treatment for serotonin syndrome aside from discontinuing the offending agent, supportive measures, and benzodiazepines for agitation. Cyproheptadine has shown some success in several small studies and case reports for patients who do not respond to initial treatment.
How do SSRIs affect depression?
As the name suggests, SSRIs exert action by inhibiting the reuptake of serotonin, thereby increasing serotonin activity.
Why are SSRIs black boxed?
In 2004, the FDA issued a black box warning for SSRIs and other antidepressant medications due to a possible increased risk of suicidality among pediatric and young adult (up to age 25) populations. The risk and benefits of initiating SSRI therapy on acutely suicidal patients must be weighed, keeping in mind that depression itself is a large risk factor for suicidality and requires treatment. Common side effects from SSRIs include sexual dysfunction, sleep disturbances, weight changes, anxiety, dizziness, xerostomia, headache, and gastrointestinal distress. [9][10]
Why is serotonin important?
Serotonin syndrome is important to keep in mind due to the widespread use of SSRIs. If suspected by a triage nurse in an emergency setting, it is important that the emergency medicine physician immediately begin supportive treatment.
Why are syringes used in psychiatric disorders?
They are often used as first-line pharmacotherapy for depression and numerous other psychiatric disorders due to their safety, efficacy, and tolerability. This activity will highlight the mechanism of action, adverse event profile, and other key factors (e.g., off-label uses, dosing, pharmacodynamics, pharmacokinetics, monitoring, ...
Why are SSRIs used?
SSRIs were originally invented with the goal of increasing levels of available serotonin in the extracellular spaces. However, the delayed response between when patients first begin SSRI treatment to when they see effects has led scientists to believe that other molecules are involved in the efficacy of these drugs. To investigate the apparent anti-inflammatory effects of SSRIs, both Kohler et al. and Więdłocha et al. conducted meta-analyses which have shown that after antidepressant treatment the levels of cytokines associated with inflammation are decreased. A large cohort study conducted by researchers in the Netherlands investigated the association between depressive disorders, symptoms, and antidepressants with inflammation. The study showed decreased levels of interleukin (IL)-6, a cytokine that has proinflammatory effects, in patients taking SSRIs compared to non-medicated patients.
How effective are SSRIs?
SSRIs are effective for the treatment of premature ejaculation. Taking SSRIs on a chronic, daily basis is more effective than taking them prior to sexual activity . The increased efficacy of treatment when taking SSRIs on a daily basis is consistent with clinical observations that the therapeutic effects of SSRIs generally take several weeks to emerge. Sexual dysfunction ranging from decreased libido to anorgasmia is usually considered to be a significantly distressing side effect which may lead to noncompliance in patients receiving SSRIs. However, for those suffering from premature ejaculation, this very same side effect becomes the desired effect .
What is the cause of serotonin syndrome?
Serotonin syndrome is typically caused by the use of two or more serotonergic drugs, including SSRIs. Serotonin syndrome is a condition that can range from mild (most common) to deadly. Mild symptoms may consist of increased heart rate, shivering, sweating, dilated pupils, myoclonus (intermittent jerking or twitching), as well as overresponsive reflexes. Concomitant use of an SSRI or selective norepinephrine reuptake inhibitor for depression with a triptan for migraine does not appear to heighten the risk of the serotonin syndrome. The prognosis in a hospital setting is generally good if correctly diagnosed. Treatment consists of discontinuing any serotonergic drugs as well as supportive care to manage agitation and hyperthermia, usually with benzodiazepines.
Why are SSRIs selective?
SSRIs are described as ' selective ' because they affect only the reuptake pumps responsible for serotonin, as opposed to earlier antidepressants, which affect other monoamine neurotransmitters as well, and as a result, SSRIs have fewer side effects.
What is the class of antidepressants?
Class of antidepressant medication. Selective serotonin reuptake inhibitor. Drug class. Serotonin, the neurotransmitter that is involved in the mechanism of action of SSRIs. Class identifiers. Synonyms. Serotonin-specific reuptake inhibitors, serotonergic antidepressants. Use.
How does serotonin reuptake work?
Serotonin reuptake inhibition. In the brain, messages are passed from a nerve cell to another via a chemical synapse, a small gap between the cells. The presynaptic cell that sends the information releases neurotransmitters including serotonin into that gap.
What is the best treatment for depression?
Depression. Antidepressants are recommended by the UK National Institute for Health and Care Excellence (NICE) as a first-line treatment of severe depression and for the treatment of mild-to-moderate depression that persists after conservative measures such as cognitive therapy.
What is SSRI short for?
SSRI is short for selective serotonin reuptake inhibitor. The SSRIs are a group of related chemical compounds that increase the amount of the neurotransmitter serotonin in the brain. Neurotransmitters ferry signals from one nerve cell to the next across a juncture known as the synapse. After relaying a message across the synapse, ...
How long does it take for SSRIs to work?
One reason is that the neurotransmitter changes happen immediately, but the drugs can take six weeks or more to provide relief of symptoms.
Why are SSRIs controversial?
SSRIs have long been controversial because they reflect a theory of depression causation that is a longstanding source of debate. While the chemical imbalance theory has been largely superseded, serotonin levels may still play a role in increasing a person’s risk for depression.
What is the role of serotonin in the body?
The increased availability of serotonin at synapses facilitates the transmission of nerve signals involved in regulating mood, appetite, biorhythms, and overall well-being. The first major SSRI to be introduced to the general public was fluoxetine, widely known by its trade name, Prozac, in 1987.
How long does it take for an antidepressant to work?
It may take trials of several drugs, alone or in combination, before a patient sees any results. It can take at least a month before a person notices improvement in mood from any one drug.
Why is it important to treat depression?
The successful treatment of depression is important. The longer that depression episodes last and the more episodes that occur, the more that depression changes the brain and becomes a chronic condition and a source of psychic pain. Patients who are prescribed an SSRI that doesn’t manage their symptoms well often feel discouraged or unwilling to try another option, further complicating their treatment prospects.
What is a trichotillomania med?
They have also been used to treat impulse-related disorders like trichotillomania (hair-pulling disorder), although evidence of their efficacy for such conditions is mixed, and they are generally not a first-line treatment. They are also used to treat eating disorders, including anorexia.
What are SSRIs used for?
SSRIs can sometimes be used to treat other conditions, such as premature ejaculation , premenstrual syndrome (PMS), fibromyalgia and irritable bowel syndrome (IBS). Occasionally, they may also be prescribed to treat pain.
How do SSRIs work?
It's thought that SSRIs work by increasing serotonin levels in the brain.
Why are SSRIs used for depression?
SSRIs are usually the first choice medication for depression because they generally have fewer side effects than most other types of antidepressant. As well as depression, SSRIs can be used to treat a number of other mental health conditions, including: generalised anxiety disorder (GAD)
How long can you take SSRI without feeling any benefit?
If you take an SSRI for 4 to 6 weeks without feeling any benefit, speak to your GP or mental health specialist. They may recommend increasing your dose or trying an alternative antidepressant.
How long do you take SSRIs?
When they're prescribed, you'll start on the lowest possible dose thought necessary to improve your symptoms. SSRIs usually need to be taken for 2 to 4 weeks before the benefit is felt.
What website has more information and advice about these SSRIs?
The Medicines Complete website has more information and advice about these SSRIs.
Does serotonin affect depression?
It would be too simplistic to say that depression and related mental health conditions are caused by low serotonin levels, but a rise in serotonin levels can improve symptoms and make people more responsive to other types of treatment, such as CBT.
What is SSRI medication?
A selective serotonin reuptake inhibitor, or SSRI, is a type of drug that is most commonly used to combat depression and anxiety.
What are the effects of SSRIs?
Not surprisingly, the first drugs designed to affect serotonin levels often caused side effects of drowsiness, weight gain, and nausea.
How long does it take for serotonin to increase?
Instead, it usually takes a week or more for a positive change in symptoms to occur.
How to reduce anxiety?
Monitoring and changing anxiety-producing thoughts is one way to make changes that will reduce anxiety. Another way is to learn ways to respond effectively in anxiety-provoking situations, rather than to avoid them. The SSRIs can often help a person accomplish these kinds of changes.
Can you take Lexapro with Paxil?
Lexapro (escitalopram) Paxil (paroxetine) Treating anxiety can be done with or without medication. But finding the right medication can be difficult. Each one is different and affects each individual differently. Before you commit to a medication, educate yourself on what exactly is entering your system.
Does neuroplasticity decrease anxiety?
This increased flexibility, or neuroplasticity, does not necessarily mean that anxiety will decrease. What it means is that your brain is more capable of making changes that will lead to a decrease in anxiety. You still need to know what to do to promote anxiety-reducing changes in your brain. Monitoring and changing anxiety-producing thoughts is one way to make changes that will reduce anxiety. Another way is to learn ways to respond effectively in anxiety-provoking situations, rather than to avoid them. The SSRIs can often help a person accomplish these kinds of changes.
Why are SSRIs prescribed?
SSRIs are the most commonly prescribed antidepressants because they tend to have few side effects. Check out examples of SSRIs, the conditions they treat, the side effects they can cause, and other factors to help you decide if an SSRI might be a good choice for you.
How do SSRIs help with depression?
The main way that SSRIs help people manage conditions like depression is by increasing serotonin in the brain. While there’s still not a definitive answer, the consensus is that depleted serotonin plays a key role in depression.
What is the best treatment for depression?
Antidepressants like SSRIs are one method to help ease the symptoms of depression, but they’re typically just part of a treatment plan.
Why do pregnant women switch to SSRIs?
Some pregnant women may switch their SSRI to reduce their risk while still treating their depression. This is because different SSRIs have different side effects. For instance, Paroxetine (Paxil) is linked with fetal heart defects as well as trouble breathing and brain disorders in the newborn.
What is the purpose of SNRIs?
Like SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs) keep the body from reabsorbing too much serotonin, allowing the brain to use more of it.
Why is serotonin called the feel good chemical?
It has been called the “feel-good chemical” because it causes a relaxed state of well-being. Normally, serotonin circulates in the brain and then absorbs into the bloodstream. Depression is linked with low levels of serotonin (as well as low levels of dopamine, ...
What are the chemicals that cause depression?
Depression is linked with low levels of serotonin (as well as low levels of dopamine, norepinephrine, and other brain chemicals).
Why are SSRIs used for depression?
In addition to depression, SSRIs may also be used to treat a range of other conditions, for example: Anxiety. Bulimia nervosa. Fibromyalgia.
How do SSRIs affect the brain?
SSRIs increase levels of serotonin in the brain by preventing the reuptake of serotonin by nerves. Having more serotonin available in the nerve synapse means that it can transmit messages easier. All SSRI antidepressants are thought to work in this way. Antidepressants relieve the symptoms of depression. SSRIs are one type of antidepressant.
What is selective serotonin reuptake inhibitor?
What are Selective serotonin reuptake inhibitors? SSRI stands for Selective Serotonin Reuptake Inhibitor. SSRI antidepressants are a type of antidepressant that work by increasing levels of serotonin within the brain. Serotonin is a neurotransmitter that is often referred to as the “feel good hormone”.
What is the best medication for depression?
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 is the function of serotonin?
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. SSRIs increase levels of serotonin in the brain by preventing the reuptake ...
Can SSRIs cause sexual dysfunction?
Not everybody experiences side effects with SSRIs antidepressants. Some of the more commonly reported side effects include: Sexual dysfunction (such as reduced desire or erectile dysfunction ). Several SSRIs have been associated with a discontinuation syndrome when they have been stopped suddenly.
Can you withdraw SSRIs slowly?
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. Read more.
What is the purpose of SSRIs?
The introduction of the SSRIs (selective serotonin reuptake inhibitors) over the past decade has provided exciting new opportunities for the treatment of obsessive-compulsive disorder (OCD). The serotonin hypothesis, based on the preferential response of OCD to the serotonin reuptake inhibitor, clomipramine, paved the way for research into ...
Is clomipramine safe for OCD?
Large, controlled, multicenter studies have found clomipramine and the SSRIs, fluoxetine, fluvoxamine, sertraline, and paroxetine, to be effective and safe in the treatment of OCD. Meta-analytic studies have reported that clomipramine is superior to the SSRIs; however, direct head-to-head comparisons suggest equal efficacy.
Overview
Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs that are typically used as antidepressants in the treatment of major depressive disorder, anxiety disorders, and other psychological conditions.
SSRIs increase the extracellular level of the neurotransmitter serotonin by limiting its reabsorption (reuptake) into the presynaptic cell. They have varying degrees …
Medical uses
The main indication for SSRIs is major depressive disorder; however, they are frequently prescribed for anxiety disorders, such as social anxiety disorder, generalized anxiety disorder, panic disorder, obsessive–compulsive disorder (OCD), eating disorders, chronic pain, and, in some cases, for posttraumatic stress disorder (PTSD). They are also frequently used to treat depersonalization disorder, although with varying results.
Side effects
Side effects vary among the individual drugs of this class and may include:
• increased risk of bone fractures
• akathisia
• suicidal ideation (thoughts of suicide) and other risks (see below)
Interactions
The following drugs may precipitate serotonin syndrome in people on SSRIs:
• Linezolid
• Monoamine oxidase inhibitors (MAOIs) including moclobemide, phenelzine, tranylcypromine, selegiline and methylene blue
• Lithium
Mechanism of action
In the brain, messages are passed from a nerve cell to another via a chemical synapse, a small gap between the cells. The presynaptic cell that sends the information releases neurotransmitters including serotonin into that gap. The neurotransmitters are then recognized by receptors on the surface of the recipient postsynaptic cell, which upon this stimulation, in turn, relays the signal. About 10% of the neurotransmitters are lost in this process; the other 90% are released from the …
History
Fluoxetine was introduced in 1987 and was the first major SSRI to be marketed.
Controversy
A study examining publication of results from FDA-evaluated antidepressants concluded that those with favorable results were much more likely to be published than those with negative results. Furthermore, an investigation of 185 meta-analyses on antidepressants found that 79% of them had authors affiliated in some way to pharmaceutical companies and that they were reluctant to report caveats for antidepressants.
See also
• List of antidepressants
• Serotonin releasing agent
• Serotonin–norepinephrine reuptake inhibitor