Examples
|
| citalopram | Celexa |
| escitalopram | Lexapro |
| fluoxetine | Prozac |
| paroxetine | Paxil |
| sertraline | Zoloft |
How It Works
Selective serotonin reuptake inhibitors
(SSRIs) can balance certain brain chemicals called
neurotransmitters. When these brain chemicals are in
proper balance, symptoms of
depression may be relieved.
Why It Is Used
Selective serotonin reuptake
inhibitors are used to treat depression and may help relieve pain after a
stroke.
How Well It Works
SSRIs are as effective in treating
depression as other types of antidepressants, such as tricyclic or tetracyclic
antidepressants and MAOIs (monoamine oxidase inhibitors). But SSRIs have
different and often less severe side effects. Some studies show that these
medicines also help relieve chronic pain, such as pain resulting from a
stroke.
Side Effects
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call 911 or other emergency services right away if you have:
- Trouble breathing.
- Hives.
- Swelling of your face, lips, tongue, or throat.
Call your doctor if you have:
- Thoughts of suicide.
- Agitation and restlessness.
- Seizures.
- Fast heartbeat.
- Nausea and vomiting.
Common side effects of this medicine include:
- Loss of sexual desire or ability.
- Irritability.
- Trouble sleeping or drowsiness.
- Headache.
- Changes in appetite.
FDA advisories. The U.S. Food and
Drug Administration (FDA) has issued:
- An
advisory on antidepressant medicines and the risk of
suicide in children and adults. The FDA does not recommend that people stop
using these medicines. Instead, a person taking antidepressants should be
watched for
warning signs of suicide. This is especially important
at the beginning of treatment or when doses are changed.
- A warning about taking triptans, used for headaches, with SSRIs
(selective serotonin reuptake inhibitors) or SNRIs (selective
serotonin/norepinephrine reuptake inhibitors). Taking these medicines together
can cause a very rare but serious condition called serotonin syndrome.
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)
What To Think About
Never suddenly stop taking antidepressants. The use of any
antidepressant should be tapered off slowly and only under the supervision of a
doctor. Abruptly stopping antidepressant medicine can cause negative side
effects or a relapse into a depressive episode or panic disorder.
SSRIs can be safer than tricyclic or tetracyclic
antidepressants, because they do not cause death if taken in large quantities
(overdose). SSRIs usually are well tolerated and effective. SSRIs also may be
safer for older adults, because the side effects are more tolerable.
People with liver
disease usually require lower doses of SSRIs.
Studies have found
daily use of SSRIs may increase the risk of bone fracture in adults over age
50. Talk to your doctor about this risk before taking an SSRI.
SSRIs make
bleeding more likely in the upper gastrointestinal tract (stomach and
esophagus). Taking SSRIs with NSAIDs (such as Aleve or Advil) makes bleeding
even more likely. Taking medicines that control acid in the stomach may
help.1
SSRIs are also used to
treat depression. SSRIs alone are not commonly used if you have episodes of
mania, such as in
bipolar disorder.
Sexual dysfunction can be a
significant problem for some people while taking an SSRI. A medicine such as
sildenafil (Viagra) may help both men
and women who have sexual problems caused by SSRIs.2, 3
Taking medicine
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
Women who take an SSRI during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating your depression or pain.
Checkups
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
References
Citations
- Abajo FJ, Garcia-Rodriguez LA (2008). Risk of upper
gastrointestinal tract bleeding associated with selective serotonin reuptake
inhibitors and venlafaxine therapy. Archives of General Psychiatry, 65(7): 795–803.
- Nurnberg HG, et al. (2003). Treatment of
antidepressant-associated sexual dysfunction with sildenafil. JAMA, 289(1): 56–64.
- Nurnberg GH, et al. (2008). Sildenafil treatment of
women with antidepressant-associated sexual dysfunction: A randomized
controlled trial. JAMA, 300(4): 395–404.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation |
|---|
| Last Revised | June 28, 2011 |
|---|
Abajo FJ, Garcia-Rodriguez LA (2008). Risk of upper
gastrointestinal tract bleeding associated with selective serotonin reuptake
inhibitors and venlafaxine therapy. Archives of General Psychiatry, 65(7): 795–803.
Nurnberg HG, et al. (2003). Treatment of
antidepressant-associated sexual dysfunction with sildenafil. JAMA, 289(1): 56–64.
Nurnberg GH, et al. (2008). Sildenafil treatment of
women with antidepressant-associated sexual dysfunction: A randomized
controlled trial. JAMA, 300(4): 395–404.
Seton is proud to have four hospitals – the only hospitals in Central Texas - that have earned the Magnet designation, the highest award for nursing excellence given by the American Nurses Association.