What are SSRIs?
Selective serotonin reuptake inhibitors (SSRIs) are a group of antidepressants of the third generation for the treatment of anxiety disorders and depression. This group includes fluoxetine (Prozac), paroxetine (Paxil), escitalopram (Lexapro), citalopram (Celexa) and sertraline (Zoloft). SSRIs are a modern and relatively easily tolerated group of antidepressants. Unlike tricyclic antidepressants (TCAs), they cause fewer side effects. The risk of cardiotoxicity with overdose is much lower. Today, this group of drugs is commonly prescribed in many countries.
SSRIs can be recommended for use in general practice. They can be easily used in an outpatient setting. Drugs of this group can be used in patients with contraindications to the use of tricyclic antidepressants (abnormal heart rhythm, angle-closure glaucoma, etc.).
In some countries, these drugs have received great popularity not only among doctors but also in society. Their names sound in movies, newspapers, literature; they became a kind of symbol of our time (“Prozac generation”). The high frequency of their use in the modern world becomes understandable, if we take into account, on the one hand, their high efficiency and safety when compared with older tricyclic antidepressants (TCAs), and on the other – if we remember the psychological and behavioral functions, which the neuromediator serotonin “manages”: maintaining the level of mood, a feeling of pleasure in its various forms, appetite and a feeling of fullness, satisfaction and sexual behavior, sensitivity to pain, the regulation of sleep and wakefulness, the level of aggressiveness and others.
Therefore, selective serotonin reuptake inhibitors are widely used to treat not only depression and anxiety disorders, but also anorexia nervosa and bulimia, and a number of sexual dysfunctions, and autoaggressive and aggressive behavior, chronic pain, pathological addiction to gambling and other mental and behavioral disorders.
Read about another group of antidepressants: Tricyclic Antidepressants
How do SSRIs work?
This group of drugs boosts mood by increasing the amount of serotonin in the brain, which is responsible for the transmission of impulses between cells (neurotransmitters). As the name implies, SSRIs act by inhibiting (blocking) the reuptake of the neurotransmitter serotonin in the brain. The blocking occurs at synapses, where brain cells (neurons) are connected with each other. Serotonin – is one of the brain chemicals, which transfers information through these connections (synapses) from one neuron to another. The action of SSRIs is shown in maintaining a high concentration of serotonin in synapses. The drug prevents the uptake of serotonin back into the nerve that sends a message. The production of new serotonin is blocked. Thus, the information continues to be transmitted, which in turn helps to activate the depressed cells and soothes the symptoms of depression.
The patient feels relief after 3 weeks of taking this group of drugs. However, to see all the results you need from six to eight weeks.
At the same time, all the side effects of SSRIs are substantially connected with increased serotonergic activity. Serotonin receptors are presented not only in the CNS and the peripheral nervous system they are also presented in bronchial smooth muscle, gastrointestinal system, vessel walls and other. Stimulation of serotonin receptors causes gastrointestinal and sexual disorders; long-term treatment with SSRIs raises the risk of bleeding.
Despite the fact that all SSRIs inhibit serotonin reuptake, they differ in the selectivity (the selectivity of the effect on serotonin receptors) and the power of this effect.
As the data show, except serotonin reuptake inhibition, these antidepressants have other so-called secondary pharmacological properties. Each of the SSRIs has its own, individual set of secondary pharmacological properties. Those secondary pharmacological properties, according to some leading researchers, distinguish one SSRI from another.
Side effects of SSRIs
In spite of the fact that side effects of this group of drugs appear more rarely than of other drugs, they still exist. Typically, selective serotonin reuptake inhibitors are well tolerated and have mild side effects. The most often occur:
- nervousness, excitement, insomnia;
- increased anxiety in the first week of the therapy;
- nausea, diarrhea;
- reduced sexual desire;
In most cases, these side effects are temporary and reversible and disappear within 1-2 weeks of the therapy.
Why should I take SSRI drugs?
Antidepressants of this group in most cases are the first drug that is prescribed for the treatment of postpartum depression. While breastfeeding, women are prescribed sertraline and paroxetine. These antidepressants are also used in the treatment of severe form of anxiety disorder, or depression in pregnant women, or to prevent depression in women who are prone to it.
Food for Thought
SSRIs are effective drugs in the treatment of postpartum depression and its prevention in women who are prone to this disease. However, there is no scientific evidence for this fact.
If you have symptoms of postpartum depression, you should consult with your doctor and choose the most suitable method of treatment together. It is proved that antidepressants and cognitive behavioral therapy are equivalent in the effectiveness of the treatment of postpartum depression. Psychotherapy and the support of loved ones are the first treatments for depression. Especially for women who have a mild form of depression, it is sufficient to attend psychotherapy. If a woman has a moderate or severe form of the disease, the doctor may prescribe a combination of antidepressants and psychotherapy.