Selective serotonin reuptake inhibitor
SSRIs are mainly used to treat:
- Major depressive disorder
- Anxiety disorders like obsessive-compulsive disorder (OCD); panic disorder; and generalized anxiety disorder
- Post-traumatic stress disorder (PTSD)
- Eating disorders
- Chronic pain
SSRIs also work well for obsessive-compulsive disorder (OCD). They are the first-choice treatment for people with very bad OCD. Like with depression and generalized anxiety disorder, SSRIs are not a cure; people need to participate in counseling and other treatments too. However, people with OCD who took an SSRI are about twice as likely to do well in treatment than people not taking an SSRI.
Fluoxetine (Prozac) and paroxetine (Paxil) are the only medications the United States Food and Drug Administration has approved for treating post-traumatic stress disorder (PTSD). Medications alone usually will not cure PTSD; they need to be combined with counseling. Except for Prozac and Paxil, most other SSRIs do not seem to help PTSD.
When a person starts to get treatment for bulimia nervosa or binge eating disorder, SSRIs can be a helpful first step. Over short periods of time, they can decrease some of the symptoms of these eating disorders. For example, for a short while, people taking SSRIs do less binge eating. However, SSRIs only seem to help for a short period of time.
Another group of antidepressants, called tricyclic antidepressants, treat chronic pain better than SSRIs do. However, tricyclic antidepressants have many more side effects than SSRIs do. Because of this, some doctors prescribe paroxetine or citalopram for chronic pain, because the side effects are not as bad.
How they workEdit
Many researchers think low levels of serotonin in the brain can help cause depression. If a person's brain does not have enough serotonin, the serotonin cannot do its job of controlling their mood. This can make the person depressed. (It can also cause other symptoms of depression, like not having any appetite, not being able to sleep, or sleeping too much - because serotonin controls appetite and sleep too.)
SSRIs increase the amount of serotonin that the brain can use. Researchers think that in depressed people, this brings the amounts of serotonin in their brains back to normal.
However, depression is complicated. So are the other problems SSRIs treat, like anxiety disorders. There is no one cause for these disorders. They are usually caused by a mixture of things. This is why SSRIs are not a cure. Most people also need counseling to help treat the other causes of their depression, anxiety, or other problems.
Each SSRI has its own possible adverse effects (side effects). It is important to remember that every medication has many possible side effects. This does not mean that everyone who takes the medication will have side effects. It only means that some people who take these medications have these symptoms.
Here are some examples of adverse effects that SSRIs can cause.
- An 80% higher risk of "possible suicidal ideation and suicidal behavior"
- About a 130% greater risk of agitation (getting angry and upset easily) and hostility (acting angry towards other people)
- Prozac, to treat children with depression
- Sertraline (Zoloft) and fluvoxamine (Luvox), for children with OCD
Scientists do not agree on whether SSRIs make adults more likely to think about suicide or try to kill themselves. The FDA says that people over age 24 are not more likely to think about suicide when they take SSRIs.
Sexual problems are one of the most common reasons why people stop taking SSRIs.
When a person takes SSRIs along with anticoagulant (blood-thinning) medications, they are a little more likely to have bleeding problems. For example, the person is more likely to have bleeding in their gastrointestinal tract, or to bleed after they have surgery. Bleeding problems are most likely in people who:
- Are on blood-thinning medications, like warfarin (Coumadin); AND
- Are on medications that keep platelets from forming blood clots, like aspirin; AND
- Are taking nonsteroidal anti-inflammatory drugs (NSAIDS), like ibuprofen; AND
- Have liver disease or liver failure.
Most SSRIs can also make a person:
- Pain in the whole body
- Strange feelings on the skin
- Trouble sleeping
- Feeling like the body is being shocked with electricity
A person and their doctor should come up with a plan for how to stop taking an SSRI. If possible, the person should slowly decrease the amount of medication they are taking, bit by bit, over a few weeks.
- Some other medicines for depression and anxiety:
- Some pain medications
- Other things
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