Selective Serotonin Reuptake Inhibitors (SSRIs)

Overview

• Purpose: Antidepressants used to treat depression and anxiety.
• Action: Inhibit reuptake of serotonin, increasing serotonin availability in the brain, improving mood.

Key Drug Names

1. Citalopram
   • Remember: Citi credit card → Citalopram
2. Escitalopram
3. Sertraline
   • Remember: Certificate → Sertraline
4. Paroxetine
   • Remember: Parrotfish → Paroxetine
5. Fluoxetine
   • Remember: Flour → Fluoxetine

Clinical Uses

• Depression: First-line treatment.
• Anxiety: Effective for general anxiety disorder, PTSD, and panic disorders.

Side Effects & Adverse Reactions

• Common Side Effects
  • Sexual dysfunction (experienced by over 50% of patients).
  • Weight gain.
• Adverse Reactions
  • Serotonin Syndrome
    • Life-threatening overload of serotonin.
    • Symptoms: Tachycardia, hypertension, muscle rigidity, agitation, diarrhea.
  • Risk increased with SSRIs and other serotonin-altering substances.

Important Considerations

• Suicidal Thoughts: Risk increases initially due to mood-energy imbalance.
• Avoid Combinations: SSRIs should not be used with MAOIs, St. John's Wort, or grapefruit.
  • MAOIs: Should not be taken within 14 days of each other to prevent serotonin syndrome.
  • St. John's Wort: Avoid due to increased risk of serotonin syndrome.
  • Grapefruit: Can alter metabolism of SSRIs, increasing dangerous serotonin levels.

Summary

• SSRIs are effective for treating depression and anxiety but come with notable side effects and interactions.
• Important to monitor for serotonin syndrome and educate patients on avoiding contraindicated substances.