Overview
This lecture covers Selective Serotonin Reuptake Inhibitors (SSRIs), their drug names, clinical uses, common side effects, potential interactions, and key safety concerns.
SSRI Drug Class and Mechanism
- SSRIs are antidepressants that inhibit reuptake of serotonin, increasing serotonin availability in the brain.
- Serotonin is a neurotransmitter associated with mood improvement ("feel-good" hormone).
SSRI Drug Names to Know
- Citalopram and escitalopram are related SSRIs.
- Sertraline, paroxetine, and fluoxetine are also common SSRIs.
- SSRIs do not share a common name ending or suffix.
Clinical Uses
- SSRIs are first-line treatments for clinical depression.
- They are also prescribed for anxiety disorders, including generalized anxiety, PTSD, and panic disorder.
Side Effects and Adverse Reactions
- Common side effects: sexual dysfunction (over 50% of patients) and weight gain.
- Risk of increased suicidal thoughts when starting SSRIs, particularly before mood improves.
- Serotonin syndrome is a serious medical emergency caused by serotonin overload, with symptoms such as hypertension, tachycardia, muscle rigidity, agitation, and diarrhea.
Important Drug Interactions and Contraindications
- Do not take SSRIs with monoamine oxidase inhibitors (MAOIs); wait at least 14 days between stopping one and starting the other.
- Avoid St. John's Wort and other serotonin-increasing substances due to risk of serotonin syndrome.
- Grapefruit should be avoided as it can alter SSRI metabolism and increase serotonin to dangerous levels.
Key Terms & Definitions
- SSRI (Selective Serotonin Reuptake Inhibitor) — Drugs that block serotonin reuptake, increasing its brain levels.
- Serotonin — A neurotransmitter that regulates mood, happiness, and anxiety.
- Serotonin Syndrome — A life-threatening condition from excess serotonin, causing overactive body systems.
- MAOI (Monoamine Oxidase Inhibitor) — Another antidepressant class that also increases serotonin.
Action Items / Next Steps
- Memorize the common SSRI drug names: citalopram, escitalopram, sertraline, paroxetine, fluoxetine.
- Review signs and symptoms of serotonin syndrome.
- Study contraindications and interactions, especially with MAOIs, St. John’s Wort, and grapefruit.
- Prepare for exam questions on SSRI side effects and nursing priorities.