The SSRI Guide: How They Work and What to Expect

Selective Serotonin Reuptake Inhibitors (SSRIs) are a class of medications primarily used to treat depression and various anxiety disorders.

They work by increasing the levels of serotonin, a neurotransmitter that plays a key role in mood regulation, in the brain. SSRIs are widely prescribed due to their efficacy and generally favorable side effect profile compared to older antidepressants, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs).

How It Works

SSRIs work by stopping neurons from reabsorbing serotonin too quickly, leaving more of it available in the brain. This extra serotonin helps improve communication between neurons and can boost mood over time. Unlike some other antidepressants, SSRIs mainly focus on serotonin without heavily affecting other brain chemicals.

Commonly Prescribed SSRIs & Why Doctors Choose Them

• Fluoxetine (Prozac) – Often chosen for major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and panic disorder. It has a long half-life, meaning it stays in the system longer, which can reduce withdrawal symptoms if a dose is missed. It’s also less likely to cause weight gain compared to some other SSRIs.
• Sertraline (Zoloft) – A go-to option for depression, OCD, PTSD, social anxiety disorder, and panic disorder. It tends to have fewer interactions with other medications and is considered a well-tolerated choice for those with anxiety-related conditions.
• Escitalopram (Lexapro) – Frequently prescribed for generalized anxiety disorder (GAD) and depression. It’s known for being well-tolerated with fewer side effects and is often preferred for people who are sensitive to medications.
• Paroxetine (Paxil) – Used for depression, anxiety disorders, PTSD, and OCD. It has strong anti-anxiety effects but is more likely to cause weight gain and withdrawal symptoms if stopped abruptly. It’s sometimes chosen when a patient has severe anxiety symptoms.
• Citalopram (Celexa) – Primarily used for depression. It’s considered a good all-purpose SSRI, but higher doses may increase the risk of heart-related side effects, so doctors may opt for other SSRIs in people with heart conditions.

When choosing the right SSRI, a doctor thinks about things like potential side effects, how long the medicine lasts in the body, how it interacts with other medications, and the patient’s specific symptoms.

Side Effects and Considerations

While generally well-tolerated, SSRIs can cause side effects, including:

• Nausea, dizziness, and headache
• Sexual dysfunction
• Insomnia or drowsiness
• Increased risk of suicidal thoughts, particularly in young adults (warning issued by the FDA)
• Discontinuation syndrome (withdrawal symptoms) if stopped abruptly

Conclusion

SSRIs have transformed the treatment of mood and anxiety disorders, providing relief to millions. Though not without side effects, their benefits often outweigh the risks for many individuals.

Consulting a healthcare provider is essential to determine the most appropriate medication and dosage for each person’s needs. If you have questions, you may always reach out to Summus.

Reviewed by Dr. Nancy Creech, Emergency Medicine Physician and SVP of Clinical Operations at Summus.