Selective Serotonin Reuptake Inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant. They are only available on prescription. SSRIs include citalopram, sertraline, fluoxetine, fluvoxamine, escitalopram, paroxetine, and vilazodone. SSRIs are usually the first-line choice of antidepressants as they cause the fewest side effects. However, SSRIs are not just used to treat depression.
They can also be used to treat other mental health conditions such as obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, post-traumatic stress disorder (PTSD), and bulimia nervosa.
Sometimes they can also be used to treat some non-mental health conditions such as premature ejaculation, premenstrual syndrome (PMS), fibromyalgia, and irritable bowel syndrome (IBS). SSRIs are mainly prescribed to adults, but some SSRIs such as fluoxetine can also be used in children. Available formulations of SSRIs can include tablets, capsules, oral drops, and oral liquids.
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How do they work?
SSRIs work by increasing the amount of serotonin in your brain. Serotonin is a chemical messenger (neurotransmitter) released by nerve cells (neurons) to help transport nerve signals between them in your brain. SSRIs block the reabsorption (reuptake) of serotonin back into neurons, allowing serotonin to pass more messages in your brain. Serotonin has various roles within your body, such as helping to regulate mood, anxiety, sleep, digestion, memory, and sexual desire.
How do I take an SSRI?
Your doctor will tell you exactly how to take your SSRI. Usually, they will start you on a low dosage and then increase it if necessary. It can take several weeks (about two to six weeks) before you start to feel the benefit of an SSRI, and you may feel worse before you feel better. Therefore, you should persist in taking your SSRI. If you want to stop taking an SSRI at any point, you should speak with your doctor first. Abruptly stopping an SSRI can result in you experiencing withdrawal effects. Your doctor will help you come off an SSRI safely by slowly reducing your dosage. Your doctor will want to check how you are getting on when you start taking an SSRI. Therefore, make sure you attend all the appointments recommended by your doctor. Most manufacturers of SSRIs advise against drinking alcohol as both alcohol and SSRIs can cause drowsiness. However, it is usually okay to drink a small amount of alcohol. If you would like to drink alcohol when taking an SSRI, you should discuss this with your doctor.
Contraindications and precautions
Do not take an SSRI if you are allergic to any of the ingredients listed in the medication. SSRIs should be used with caution in people with certain medical conditions such as epilepsy, bipolar disorder (with a history of mania), heart disease, diabetes, liver problems, and kidney problems.
Potential side effects
As with all medications, some people may experience side effects. If any side effects become bothersome, you should speak with your doctor or pharmacist. Some common side effects from SSRIs can include:
- feeling sick
- being sick
- dry mouth
- drowsiness
- headache
- dizziness
- anxiety
- low sex drive
- difficulty concentrating
- blurred vision
- excessive sweating
If you experience drowsiness, you should avoid driving.
Rarely some people may develop suicidal thoughts when they first start taking an SSRI. You should urgently speak with your doctor if this happens.
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