Treatments > Biological > Medication > SSRIs
SSRIs
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Examples:
- fluoxetine
- paroxetine
- citalopram
- escitalopram
- sertraline
- fluvoxamine
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Increase available levels of the neurotransmitter serotonin
- The nerve cells normally recycle serotonin by soaking it back up again. The SSRIs work by stopping (inhibiting) this re-uptake of serotonin. As the serotonin is not soaked up again, more will be present to pass on messages to nerve cells nearby.
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Delay in onset: takes 2-4 weeks to be effective.
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Not addictive but can get discontinuation syndromes.
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No more effective than TCAs but less toxic in overdose.
Side-effects
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Common
- Nausea and vomiting, sexual dysfunction, insomnia.
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Less common
- Drowsiness, headache, loss of appetite, diarrhoea.
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Uncommon
- Restlessness/anxiety.
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Rare
- Suicidal ideas/rash/dry mouth/tremors and dystonias.
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SSRIs are associated with an increased risk of bleeding.
- Consider prescribing a gastroprotective drug in older people who are taking non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin.
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Fluoxetine, fluvoxamine and paroxetine have a higher propensity for drug interactions.
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For people who also have a chronic physical health problem, consider using citalopram or sertraline as these have a lower propensity for interactions.
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Paroxetine is associated with a higher incidence of discontinuation symptoms (shorter half-life).
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Fluoxetine/sertraline in children and young people due to possible increase in suicidal thoughts.