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SSRIs: An Overview
Introduced to the nation in 1987, selective serotonin reuptake inhibitors (SSRIs) are a newer class of prescription medications designed to relieve depression and anxiety disorders. SSRIs are also used to treat a variety of other psychiatric and physical conditions, including bulimia nervosa, alcoholism, borderline personality disorder, posttraumatic stress disorder (PTSD) and obesity. Generally speaking, SSRIs are the antidepressants of choice for many of today's physicians. They are praised as being more effective, safer and better tolerated than older classes of drugs.
What Medications Belong to the SSRI Class?
The first medication in the SSRI category was Fluoxetine, sold under the brand name Prozac. Prozac was approved by the FDA in December 1987. Five more SSRIs followed, including:
- Zoloft (sertraline hydrochloride), manufactured by Pfizer, Inc.
- Paxil (paroxetine hydrochloride), manufactured by GlaxoSmithKline
- Luvox (fluvoxamine maleate), manufactured by Solvay Pharmaceuticals. Luvox was the subject of much public scrutiny after it was discovered that one of the two teenage shooters in the Columbine high school massacre had been taking the drug. It was pulled from the market in 2002.
- Celexa (citalopram hydrobromide), manufactured by Forest Pharmaceuticals, Inc.
- Lexapro (escitalopram oxalate), manufactured by Forest Pharmaceuticals, Inc. Lexapro is considered to be an improved version of Celexa.
With the exception of Luvox, all of these SSRIs are widely prescribed in the U.S. today.
How Do SSRIs Work?
In the human brain, special chemicals called neurotransmitters transmit signals between nerve cells. Research suggests that problems with neurotransmitter activity can negatively affect a person's moods and behavior. Specifically, low levels of the neurotransmitters serotonin and norepinephrine have been linked to depression and other mood disorders. Conversely, an increase in these levels has been found to relieve feelings of depression and elevate mood.
SSRIs are believed to work by blocking the reabsorption, or reuptake, of serotonin by certain nerve cells in the brain. This mechanism makes more serotonin available, which is thought to enhance the transmission of chemicals in the brain and improve overall mood. SSRIs are called "selective" due to the fact that they appear to only affect serotonin, not other neurotransmitters.
Side Effects of SSRIs
While SSRIs are considered relatively safe when used as prescribed, they have been known to produce a wide range of side effects in people taking them. In general, side effects include:
- increased sweating
- weight gain
- diarrhea
- loss of appetite
- nervousness
- rash
- agitation
- tachycardia (rapid heartbeat)
- restlessness
- drowsiness
- insomnia
- nausea
- sexual dysfunction
- headache
Since every SSRI has its own unique chemical makeup, individual patients may respond differently to a single SSRI. In the same token, each patient may experience varied side effects with different types of SSRIs.
For the individual taking the medication, SSRI side effects are rarely severe enough to require a reduction in dosage or discontinuation. However, when taken by an expectant mother during pregnancy, SSRIs may pose significant health dangers for another, unknowing victim: the unborn fetus. Studies have linked the use of SSRIs during pregnancy with an increased risk of persistent pulmonary hypertension of the newborn (PPHN), a life-threatening condition that affects a baby's ability to breathe after birth.