Treatments  > Biological > Medication > SSRIs


  • Examples: 

- fluoxetine

- paroxetine

- citalopram

- escitalopram

- sertraline

- fluvoxamine


  • 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.


  • Delay in onset: takes 2-4 weeks to be effective.


  • Not addictive but can get discontinuation syndromes.


  • No more effective than TCAs but less toxic in overdose.




  • Common

- Nausea and vomiting, sexual dysfunction, insomnia.


  • Less common

- Drowsiness, headache, loss of appetite, diarrhoea.

  • Uncommon

- Restlessness/anxiety.


  • Rare

- Suicidal ideas/rash/dry mouth/tremors and dystonias.


  • 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.


  • Fluoxetine, fluvoxamine and paroxetine have a higher propensity for drug interactions.


  • For people who also have a chronic physical health problem, consider using citalopram or sertraline as these have a lower propensity for interactions.


  • Paroxetine is associated with a higher incidence of discontinuation symptoms (shorter half-life).


  • Fluoxetine/sertraline in children and young people due to possible increase in suicidal thoughts.