Selective Serotonin Reuptake Inhibitors (SSRIs) are a class of medications commonly
prescribed to treat depression and a variety of other mental health disorders. SSRIs work
by increasing the levels of serotonin, a neurotransmitter in the brain that contributes to
feelings of well-being and happiness. By blocking the reabsorption (reuptake) of serotonin
into neurons, SSRIs make more serotonin available to improve communication between
brain cells.
SSRIs are primarily used to treat major depressive disorder (MDD), but they are also
effective in managing anxiety disorders, obsessive-compulsive disorder (OCD), panic
disorder, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder
(PMDD). Common SSRIs include fluoxetine (Prozac), sertraline (Zoloft), citalopram
(Celexa), escitalopram (Lexapro), paroxetine (Paxil), and fluvoxamine (Luvox).
SSRIs are often preferred over older antidepressants like tricyclic antidepressants (TCAs)
and monoamine oxidase inhibitors (MAOIs) because they generally have fewer side
effects and a better safety profile. However, they can still cause side effects, particularly
when treatment is initiated or doses are adjusted. Common side effects include nausea,
headache, insomnia, sexual dysfunction, dry mouth, and drowsiness. These symptoms
often lessen over time, but sexual side effects can persist in some individuals.
One important consideration with SSRIs is the risk of serotonin syndrome, a rare but
serious condition that can occur when serotonin levels become too high, often due to
combining SSRIs with other serotonergic drugs. Symptoms may include confusion,
agitation, rapid heart rate, dilated pupils, and muscle rigidity. Another concern is the
increased risk of suicidal thoughts or behaviors in children, adolescents, and young
adults during the initial stages of treatment, which is why careful monitoring is essential.
SSRIs typically take 2 to 4 weeks to begin showing noticeable effects, and full benefits may
not be felt for up to 6 to 8 weeks. Once symptoms improve, patients are usually advised to
continue the medication for several months or longer to prevent relapse. Discontinuation
should be done gradually under medical supervision to avoid withdrawal symptoms, also
known as discontinuation syndrome.
