SSRI Drugs – antidepressant (anxiety disorders)

Selective Serotonin Reuptake Inhibitor (SSRI)

Q: What is purpose of drug?

A: Type of depressant that treats both major depressive disorders and anxiety disorders.  Can help overcome depression.  Ease symptoms of moderate to severe depression.  Aside from depression, SSRI can also treat anxiety disorders.

Q: What are some benefits of this particular form of drug?

A: Relatively safe and typically causes fewer side effects than other types of antidepressants

Q: What are some examples of FDA approved drug names?  I create URL links to point to sites within

A: Citalopram (Celexa)

A: Escitalopram (Lexapro)

A: Fluoxetine (Prozac)

A: Paroextine (Paxil, Pexeva)

A: Sertraline (Zoloft)

Q: Which drug is best to take?

A: Depends on a numbers of issues – symptoms, health conditions.

Q: What is Serotonin?

A: Serotonin is one of the chemical messengers (neurotransmitter) that carry signals between brain nerve cells (neurons).

Q: How do SSRI drugs work?

A: They block/inhibit the absorption (reuptake) of serotonin into neurons.  They increase levels of serotonin in the brain.  By having more serotonin in the brain, it improves transmission of messages between neurons.  The keyword “selective” is used because SSRI’s mainly affect serontonin, and not other neurotransmitters.

A: SSRIs differ in their potencies at blocking serotonin reuptake and in how quickly the body eliminates (metabolizes) the drug.

Q: What are some potential side-effects of SSRI?  If you can’t tolerate one SSRI, you may by able to tolerate a different one.

A: Nausea, vomiting or diarrhea

A: Headache

A: Drowsiness

A: Dry mouth

A: Insomnia

A: Nervousness, agitation or restlessness

A: Dizziness

A: Sexual problems, such as reduced sexual desire, difficult reaching orgasm or inability to maintain an erection (erectile dysfunction).

A: Impact on appetite, leading to weight loss or weight gain.

Q: What are suggestions on usage?

A: Take meds with food – may reduce risk of nausea.  Can take at bedtime, to reduce impact of nausea, if it doesn’t keep you from sleeping.

Q: What are some safety issues or concerns?

A: SSRIs are generally safe for most people.

A: High doses of citalopram (Celexa) may cause dangerous abnormal heart rhythms.  Avoid doses over 40mg a day.  Recommended max dose is 20mg for patients over age 60.

Q: What are some contraindications to be aware of?

A: Inform doctor of any other OTC meds, herbs or other supplements being taken.

A: SSRIs may increase risk of bleeding.  Issue being with other meds that increase risk of bleeding – nonsteroidal antiinflammatory drugs (NSAIDs), aspirin, warfarin (Coumadin) and other blood thinner.

Q: What about having too much Serotonin?  Serotonin Syndrome.

A: This is rare, but the issue is when too much accumulates.  Typically because of combining meds with something like the herbal supplement St. John’s wort.

A: Serotonin Syndrome is signs and symptoms of anxiety, agitation, high fever, sweating, confusion, tremors, restlessness, lack of coordination, major changes in blood pressure and a rapid heart rate.

Q: Any issues with antidepressants and pregnancy?

A: Talk to doctor to review various risks and meds options.

Q: Any concerns with suicide risk with antidepressants?

A: Generally safe, but FDA has strict control over this, and primary area of focus is age 25 and lower.  Antidepressant are more likely to reduce suicide risk in the long run by improving mood.

Q: How do you stop taking antidepressants?

A: Not a good idea to just stop cold, as you could get withdrawal symptoms – discontinuation syndrome.

A: Symptoms of withdrawal include general feeling of uneasiness, nausea, dizziness, lethargy, flu-like symptoms.

Q: Is there a one size fits all drug for everyone?

A: No.  Each person reacts different to each type of antidepressant.  If a drug worked well for a close relative, this should be a primary drug choice to consider, because of inherited trait.  Blood tests can also help fine down the choice.  It can take several weeks or longer for an antidepressant to be fully effective, requires keeping a log and having some patience.

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