What you need to know about SSRIs

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If you or someone you know is taking medicine to treat depression, it might be a selective serotonin uptake inhibitor — more commonly referred to as an SSRI.

SSRIs are the most commonly prescribed medication to treat depression. They’re also used to treat other mental health conditions such as generalized anxiety disorder, post-traumatic stress disorder, and obsessive-compulsive disorder.

Fluoxetine — best known by its trade name of Prozac — was the first major SSRI to be introduced to the public back in 1987. Other SSRIs include sertraline (Zoloft), citalopram (Celexa), paroxetine (Paxil, Brisdelle, Pevexa), and escitalopram (Lexapro). While all these medications work similarly, their structures are a bit different, so what works for one person might not work for another.

How SSRIs work

Brain cells, called neurons, use chemicals called neurotransmitters to send messages to each other. After a neuron sends a message, it reabsorbs the neurotransmitter so it can send the next message. SSRIs block neurons from reabsorbing — or reuptaking — a neurotransmitter called serotonin, which is a natural mood booster. Higher levels of serotonin make you feel calmer, more focused, and emotionally stable.

Effectiveness

SSRIs are considered the most effective antidepressants. About a third of the people who take SSRIs experience complete relief from symptoms of depression, and another third feels partial relief. However, these types of medication don’t work for everyone; a third of people who use them don’t see a difference.

Studies have shown that SSRIs and other antidepressants work best when they’re combined with psychological therapy, healthy eating, and exercise.

Side effects

SSRIs generally have fewer side effects than other antidepressants. Most side effects are minor and usually go away as your body gets used to the medication.

Possible side effects of most SSRIs include:

• Nausea, diarrhea, or vomiting
• Headaches
• Dry mouth
• Increased sweating
• Drowsiness or insomnia
• Sexual problems
• Changes in appetite that can lead to weight gain or loss
• Rash
• Joint or muscle pains
• Blurred vision
• Agitation or nervousness
• Dizziness
• Anxiety

Risks and complications

SSRIs may increase the risk of suicidal thoughts in children, teens, and adults younger than 25. This side effect usually occurs during the first few weeks of taking the medication or after a change in dosage.

It’s important for parents to closely monitor children and adolescents who are prescribed SSRIs. Their doctor should be contacted immediately if any sudden changes are noticed, including:

• Aggressive or hostile behavior
• An extreme increase in movement and talking
• Making suicidal statements
• Trouble sleeping
• Withdrawing from friends and family

SSRIs may interfere with the effectiveness of other medications. They also may cause dangerous reactions, including serotonin syndrome, when combined with other medications or supplements.

Most SSRIs are considered safe to use during pregnancy. The following risks, although rare, have been linked to SSRI use during pregnancy:

• Abdominal, heart, and lung birth defects
• Blood loss after childbirth
• Miscarriage or premature birth
• Psychiatric disorders in children
• Withdrawal symptoms in newborns exposed to SSRIs in the last trimester

If you're pregnant, or taking other medications, be sure to talk to your doctor to understand any possible risks associated with SSRIs.

Beginning and discontinuing SSRIs

SSRIs usually take four to six weeks to start working. Suddenly stopping them or skipping doses can cause discontinuation syndrome, which can cause feelings of uneasiness, nausea, dizziness, lethargy, and flu-like symptoms. For these reasons, it’s important to gradually come off an SSRI under the guidance of a health care provider.

When combined with psychotherapy, SSRIs can be an effective way to help combat depression. Finding the right one and dosage may take some time, but for many, the results are well worth it.