If you or a loved one suffer from depression or an anxiety disorder and are curious about selective serotonin reuptake inhibitors (SSRIs), we’ve compiled some basic information about them here.
Only your psychiatrist can work with you to determine whether SSRIs are the right course of treatment. Individuals have different experiences with different medications and dosages, and it often takes some closely monitored experimentation to arrive at the most effective treatment that causes the fewest side effects. Also, any medication works best in conjunction with other types of treatment, such as talk therapy, cognitive behavioral therapy, and positive lifestyle changes.
What Conditions Do SSRIs Treat?
SSRIs are the most commonly prescribed antidepressant. They’re typically used to treat moderate to severe cases of clinical depression, as well as anxiety disorders like generalized anxiety, obsessive-compulsive disorder (OCD), eating disorders, social anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD).
How Do SSRIs Help?
SSRIs increase levels of serotonin by blocking its reuptake by nerves (they don’t increase production of serotonin). Serotonin is a neurotransmitter that, among other things, helps regulate your sleep cycle and appetite, and it’s sometimes called “the feel-good chemical” because it can boost your mood, reduce anxiety, and promote a feeling of relaxation.
Depression and anxiety disorders are linked to low levels of serotonin, as well as low levels of other naturally occurring chemicals like dopamine and norepinephrine.
What Types of SSRIs Are Available?
There are five selective serotonin reuptake inhibitors approved by the FDA to treat depression and anxiety disorders, and they’re all believed to work the same way to help manage depression. However, they have some varying side effects, contraindications, and potential interactions with other drugs and supplements; it’s important that all doctors prescribing for you are aware of all the other medications and supplements you take.
The generic drug names are below, and in parentheses are the major brand names of each type.
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
- Paroxetine (Paxil, Pexeva)
- Sertraline (Zoloft)
Not all SSRIs are used to treat all the same conditions. For example, the brand-name drug Brisdelle is a form of paroxetine that’s used to treat symptoms of menopause, and is not used to treat psychiatric disorders. For another example, the generic SSRI fluvoxamine is primarily used to treat a few types of anxiety disorder.
What Side Effects can SSRIs Cause?
One key advantage to selective serotonin reuptake inhibitors is that they tend to cause fewer and less bothersome side effects than other types of antidepressants—especially at higher doses—like tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs).
However, different people have different experiences with medications. Each patient and care provider must determine whether the benefits outweigh the downsides. It’s often possible to find a better balance by adjusting the prescribed dosage, and in many cases side effects subside with continued use.
Also, different types of SSRI can cause different side effects. But generally speaking, common side effects of SSRIs include:
- Dry mouth
- Nausea, vomiting, diarrhea, and/or other digestive upset
- Increased or decreased hunger (and associated weight gain or loss)
- Difficulty falling or staying asleep
- Feeling nervous, restless, or agitated
- Increased sweating
- Sexual dysfunction (e.g., decreased libido, difficulty reaching orgasm or maintaining an erection)
What Are Other Possible Concerns when Taking SSRIs?
In addition to side effects, there are other potential concerns when taking selective serotonin reuptake inhibitors. These can include:
- Allergic reactions
- Dangerous interactions with other drugs or supplements
- Increased risk of bleeding (especially concerning if you take other drugs or supplements that increase this risk, like aspirin or other NSAIDs, anticoagulants or blood thinners, ginkgo biloba, ginseng, St. John’s wort, etc.)
- Harm to the fetus or infant if you’re pregnant or breastfeeding
- Increased suicidal thoughts/risk of suicide
- Withdrawal symptoms if you abruptly stop taking an SSRI or miss several doses (however, SSRIs are not considered addictive)
- Serotonin syndrome (an excess of serotonin, which becomes more likely if you combine an SSRI with another drug or supplement that increases serotonin levels); symptoms include anxiety, agitation, restlessness, perspiring, high fever, confusion, tremors, loss of coordination, changes in blood pressure, and rapid heart rate; seek emergency medical attention if you suspect you or your loved one is experiencing this rare complication