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selective serotonin reuptake inhibitors

What is Selective Serotonin Reuptake Inhibitors?

Selective serotonin reuptake inhibitors are the most commonly used antidepressants. They ease the symptoms of moderate to severe depression, are safe to use, and usually cause fewer side effects than other types of antidepressants. Although it is thought that all SSRI antidepressants work in the same way, there are differences between individual SSRIs on how long they remain in the body, the way they are metabolized, and how much they interact with the other medications a patient is currently taking.

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SSRIs are used for the treatment of depression as they increase the levels of serotonin in the brain. Serotonin is a chemical messenger or neurotransmitter that carries signals between brain nerve cells.

SSRIs block the reabsorption or reuptake of serotonin into neurons, making the neurons more able to improve the transmission of messages between neurons. SSRIs are referred selective because they affect serotonin only and not the other neurotransmitters.

In addition to depression, SSRIs may also be used for the treatment of anxiety disorders.

Side effects and cautions

All SSRIs are believed to work in a similar way and they generally cause similar side effects, although not everyone may experience any. Many side effects tend to go away after the first few weeks of treatment, while others may require the patient and his doctor to try a different drug.

If you are unable to tolerate one SSRI, you may find a different SSRI that you can tolerate. SSRIs differ in their potencies at blocking serotonin reuptake and in how fast they are eliminated or metabolized by the body.

The following are the possible side effects of SSRIs:

  • Headache
  • Nausea, diarrhea, vomiting
  • Dry mouth
  • Drowsiness
  • Insomnia
  • Dizziness
  • Nervousness, restlessness, or agitation
  • Sexual problems such as reduced sexual desire and erectile dysfunction
  • Impact on appetite leading to either weight loss or weight gain

Taking SSRIs with food may reduce the risk of nausea. If your medicine does not keep you from sleeping, you can reduce the impact of nausea by taking it at bedtime.

The type of antidepressant that will work best for you depends on several factors, such as the symptoms that you experience and other health conditions that you might have. When given a prescription for SSRI, ask your doctor or pharmacist about its possible side effects.

Safety issues

SSRIs are generally safe for most patients. However, there are some circumstances when the SSRIs can cause problems. An example is the drug citalopram. High doses of this drug may cause dangerous abnormal heart rhythms. The manufacturer recommends against using 40 mg of the drug daily.  People who are over the age of 60 should only take a maximum daily dose of not more than 20 mg.

Discuss with your doctor the following issues before you take an SSRI:

  • Drug interactions – Before taking an antidepressant, share with your doctor a list of all the medications you are taking for possible interactions
  • Serotonin syndrome – In rare cases, an antidepressant can result in high levels of serotonin accumulating in your body.
  • Antidepressant and pregnancy – The risk and benefits of antidepressants while pregnant must be discussed with your doctor.