SSRIs: Selective Serotonin Reuptake Inhibitors
Overview
- Class of antidepressants used to treat depression and anxiety.
- Effective medication with potential side effects and adverse reactions.
Mechanism of Action
- Block or inhibit the reuptake of serotonin.
- Increases serotonin availability in the brain (feel-good neurotransmitter).
Common SSRI Drug Names
- Citalopram: Remember with the mnemonic: Citi (Citi credit card).
- Escitalopram: Related to citalopram (remember together).
- Sertraline: Remember with the mnemonic: certificate (sushi chef certificate).
- Paroxetine: Remember with the mnemonic: parrotfish.
- Fluoxetine: Remember with the mnemonic: flower (begins similarly).
Clinical Uses
- Depression: First-line treatment, increases serotonin levels to improve mood.
- Anxiety: Used for General Anxiety Disorder, PTSD, panic disorders.
- Overall preferred over other antidepressants like TCAs or MAOIs due to fewer side effects.
Important Considerations
- Suicidal Thoughts: Potential increase in suicidal thoughts short-term before mood improves (due to energy increase prior to mood lift). Priority patient safety issue.
- Time to Act: SSRIs can take up to four weeks to impact mood.
Common Side Effects
- Sexual Dysfunction: Affects over 50% of patients (decreased libido, difficulty achieving orgasm).
- Weight Gain: Encourage a healthy diet and exercise to mitigate.
Adverse Reactions
- Serotonin Syndrome: Life-threatening, caused by too much serotonin.
- Symptoms: tachycardia, hypertension, muscle rigidity, agitation, restlessness, diarrhea.
- Emergency: Notify provider, do not administer SSRI if suspected.
Drug Interactions and Warnings
- MAOIs: Avoid taking with SSRIs (require 14-day separation to prevent serotonin syndrome).
- St. John’s Wort: Herb increasing serotonin levels - avoid.
- Grapefruit: Alters drug metabolism, increases serotonin levels - avoid.
Recap
- SSRIs: Effective in treating depression and anxiety.
- Common drugs: citalopram, escitalopram, sertraline, paroxetine, fluoxetine.
- Side effects: sexual dysfunction, weight gain.
- Adverse reaction: serotonin syndrome.
- Avoid: MAOIs, St. John’s Wort, grapefruit products.
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