Highlights
- Selective serotonin reuptake inhibitors, or SSRIs, are a class of antidepressants that help to regulate mood and emotions.
- SSRIs work by limiting the amount of serotonin reabsorbed by neurons after its release.
- SSRIs treat various conditions, including depression, anxiety, extreme phobias, bulimia, obsessive-compulsive disorder, post-traumatic stress disorder, and some symptoms of bipolar disorder.
- Side effects can vary but may include a loss of appetite, weight changes, nausea, indigestion, diarrhea, and changes in sleep, among others.
- SSRIs may not be right for people with a history of seizures, cardiac risk factors, or those who are pregnant or breastfeeding.
- Antidepressants, including SSRIs, have been shown to increase the risk of suicidal thoughts in adolescents and young adults.
Depression is not just a fleeting case of the blues. For 280 million individuals worldwide, depression is a crippling mental condition that severely impacts their quality of life. Treatments like selective serotonin reuptake inhibitors (SSRIs) provide much-needed relief from depressive symptoms and make living a normal life possible.
Despite their many benefits, SSRIs aren’t without drawbacks. They may not be right for everyone, so it’s important to understand how they work and who is a good candidate for them.
This guide to SSRIs covers what you need to know, including their indications, side effects, warnings and contraindications, and more.
How Do SSRIs Work?
SSRIs are a class of medication used to treat depression and other mood disorders. They target the reuptake of serotonin, a neurotransmitter responsible for regulating mood, emotions, and behavior.
Approved conditions that SSRIs can be used for include:
- Depression
- Anxiety
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Symptoms of bipolar disorder
- Bulimia
- Post-traumatic stress disorder (PTSD)
- Symptoms of severe phobias, such as agoraphobia
Serotonin travels between neurons to transmit signals. Upon release into the synapse (the gap between neurons), some serotonin is reabsorbed by the neuron that released it, a process called reuptake.
SSRIs block reuptake, which increases the amount of serotonin in the synapse. SSRIs bind to the serotonin reuptake pumps on the neuron to prevent reabsorption.
With more serotonin available, it can continue to stimulate receptors on neighboring neurons for longer periods of time. This alleviates some of the symptoms of depression and regulates mood and emotions.
Over time, the brain may adapt to the increased levels of serotonin by making adjustments to the sensitivity of receptors. SSRIs typically need to be taken for two to four weeks before the full benefits are felt.
Description and Examples of SSRIs
The term “SSRI” refers to a class of medications for depression that share a similar mechanism of action. They are one of many classes of antidepressants available and should be used under a doctor’s supervision to ensure proper dosage and monitor for side effects.
Specific properties of SSRIs can vary by drug, including:
- Potency
- Half-life
- Metabolism rate
- Approved uses
- Dosages
Examples of SSRIs include:
- Fluoxetine (Prozac)
- Citalopram (Celexa)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Escitalopram (Lexapro)
- Fluvoxamine (Luvox)
Warning and Contraindications — SSRIs
While SSRIs are effective in treating mood disorders, they may not be suitable for everyone. Different SSRIs may carry different warnings, so it’s important to check with your doctor regarding your specific prescription.
Warnings
- Increased risk of suicidal thoughts and behaviors. SSRIs have been shown to increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. If you or someone you know is taking an SSRI and experiences any thoughts of suicide or self-harm, it is important to seek help immediately.
- Serotonin syndrome. Serotonin syndrome is a rare but potentially life-threatening condition that can occur when SSRIs are taken with other medications that increase serotonin levels, such as other antidepressants, tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), or supplements such as St. John’s wort. Symptoms of serotonin syndrome can include fever, agitation, confusion, muscle rigidity, seizures, and coma.
- Mania. SSRIs can trigger mania or hypomania in people with bipolar disorder.
- Seizures: SSRIs can increase the risk of seizures in people with a history of seizures.
Precautions
- Pregnancy and breastfeeding. SSRIs are generally considered safe to take during pregnancy and breastfeeding, but it is important to talk to your doctor about the risks and benefits.
- Driving and operating machinery. SSRIs can cause dizziness, drowsiness, and blurred vision, so it is important to use caution when driving or operating machinery until you know how they affect you.
- Alcohol. Alcohol can increase the side effects of SSRIs, so it is best to avoid alcohol while taking them.
- Other medications. SSRIs can interact with other medications, so it is important to tell your doctor about all of the medications you are taking before starting an SSRI.
Please note that this is not a complete list of warnings and precautions. It is important to talk to your doctor about the specific risks and benefits of SSRIs — and your specific prescription — for you.
General Tips
- Start with a low dose and gradually increase it. This can help to reduce the risk of side effects.
- Take your medication as prescribed. Do not take more or less than prescribed, and do not stop taking your medication without talking to your doctor.
- Tell your doctor about any side effects you experience. This will help your doctor to adjust your dosage or switch you to a different medication if necessary.
- Adverse reactions may occur upon discontinuation of SSRIs, especially after an abrupt discontinuation. It’s advised to gradually reduce your dosage to mitigate adverse effects.
Side Effects — SSRIs
As with all medications, SSRIs may create unwanted side effects. Common minor side effects may include:
- Nausea
- Loss of appetite
- Diarrhea
- Indigestion
- Increased sweating
- Tremor or shaking
- Agitation
- Changes in sleep
- Anxiety
- Fatigue
- Decreased libido or other sexual changes
- Nose bleeds
- Weight changes
Less common but more serious side effects may include:
- New or worsening symptoms
- Unusual mood changes
- Thoughts of suicide or self-harm
This is not a complete list of side effects. Talk to your doctor right away if you experience any of the less common but more serious side effects or if you are concerned about any other side effects.
If you or a loved one experiences thoughts of suicide or self-harm while taking SSRIs (or at any time), you can reach the Suicide and Crisis Lifeline by texting or dialing 988. Help is available free of charge 24 hours a day, seven days a week.
Drug Interactions — SSRIs
Drug interactions may vary with each medication. For potential interactions for a specific SSRI, visit the Drugs.com Drug Interaction Checker.
In general, SSRIs can interact with the following medications:
- Other antidepressants. Taking SSRIs with other antidepressants, such as tricyclic antidepressants (TCAs) or monoamine oxidase inhibitors (MAOIs), can increase the risk of serotonin syndrome, a potentially life-threatening condition.
- Blood thinners. SSRIs can increase the risk of bleeding when taken with blood thinners, such as warfarin or aspirin.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). SSRIs can increase the risk of stomach upset and bleeding when taken with NSAIDs, such as ibuprofen or naproxen.
- Anticonvulsants. SSRIs can lower the blood levels of some anticonvulsants, such as valproate or phenytoin.
- Lithium. SSRIs can increase blood levels of lithium, which can lead to lithium toxicity.
- Medications that affect the liver. SSRIs can interact with medications that are metabolized by the liver, such as some antipsychotics and antidepressants.
- Medications that affect the heart. SSRIs can increase the risk of arrhythmias (irregular heartbeats) when taken with medications that prolong the QT interval, such as some antiarrhythmics and antidepressants.
It is important to talk to your doctor about all of the medications you are taking before starting an SSRI. They can help you determine if there is any risk of interaction and adjust your dosage if necessary.
Here are some general tips for avoiding drug interactions with SSRIs:
- Tell your doctor about all of the medications you’re taking, including prescription, over-the-counter, and herbal remedies and supplements.
- Bring a list of your medications with you to your doctor’s appointments.
- Ask your doctor or pharmacist about potential drug interactions before taking any new medication.
- Take your medications exactly as prescribed by your doctor.
- Don’t stop taking any medication without first talking to your doctor.
No list of potential drug interactions is complete, so let your provider know if you experience any new or unusual symptoms after taking this medication.
Conclusion
SSRIs are powerful medications that can help people with depression gain a higher quality of life. They’ve been shown to be effective in treating mood-related disorders by adjusting serotonin levels in the brain.
However, the effectiveness of these medications can vary by individual. Given their numerous side effects and the potential to increase thoughts of suicide or self-harm, it’s important to speak with your healthcare provider about the benefits vs. the risks and make an informed decision for your health.
Find the Lowest Price for SSRIs
If an SSRI is right for you, BidRX can help you find your medication at the most affordable price. Create a free account, post your prescription, and let pharmacies compete for your business. You can choose the offer that works best for your budget. It’s that easy!
Find the lowest price for SSRIs—get started today.
This information is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication.
