If you are facing a diagnosis of depression and are considering antidepressants for treatment, you may want to know more about selective serotonin reuptake inhibitors (SSRIs), and if this type of antidepressant is right for you. Or, you may have already been prescribed an SSRI by your psychiatrist and are wondering how the medication works or what side effects it’s possible to experience.
It’s always smart to research a drug before you begin to take it. While there should be no stigma attached to medical treatment for depression, more knowledge of safety precautions and potential side effects will make you that much more confident about beginning your journey toward feeling better.
What Are Selective Serotonin Reuptake Inhibitors (SSRIs)?
Serotonin reuptake inhibitors increase the amount of serotonin in your body. People with depression often experience serotonin imbalance, which contributes to their low mood. This is because serotonin is a hormone and neurotransmitter your body naturally produces, and it contributes to feelings of overall wellness and happiness. People with depression often experience imbalances of serotonin, and SSRI drugs help decrease this imbalance.
SSRI drugs are the most commonly prescribed antidepressant, primarily because they are effective at improving depression symptoms and have fewer side effects than other comparable antidepressants.
In addition to depression, SSRI drugs can help improve symptoms of:
- Post traumatic stress disorder (PTSD)
- Obsessive Compulsive Disorder (OCD)
- Panic disorder
- Eating disorders
- Premenstrual dysphoric disorder (PMDD)
How Do SSRIs Work?
Serotonin is a neurotransmitter released by a nerve cell to communicate with a target cell. Soon after the message is sent, serotonin levels decrease or become reabsorbed by another nerve cell. This phenomenon where a nerve absorbs a neurotransmitter that’s been secreted is called “reuptake.” What SSRI drugs do is prevent this reuptake, thereby ensuring that your body has higher amounts of serotonin. SSRI drugs affect serotonin specifically, meaning they do not inhibit reuptake of other neurotransmitters, hence the name “selective serotonin reuptake inhibitors.”
Researchers believe that it is this serotonin imbalance that leads to depression. This could be a biochemical problem in the production, processing, or travel of serotonin, but researchers believe the resulting chemical imbalance is what contributes to the depression symptoms that affect our mood.SSRI drugs help balance serotonin in the body and thus work to decrease depression symptoms. Selective serotonin reuptake inhibitors do not trigger your body to produce more serotonin, but rather optimize the way your body processes this “feel-good” hormone.
Which SSRIs Are Approved To Treat Depression?
Several SSRI drugs are approved by the FDA to treat depression. You can work with your doctor or psychiatrist to find one that is best suited to your needs. The most commonly prescribed SSRI drugs include:
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
- Paroxetine (Paxil, Pexeva)
- Sertraline (Zoloft)
- Fluvoxamine (Luvox, Luvox CR)
- Vilazodone (Viibryd)
What Are The Possible Side Effects of SSRIs
Most doctors agree that SSRI drugs generally have fewer side effects than other antidepressants. Usually, the side effects are most prominent when you begin taking the medication and subside as time goes on. However, some of these side effects may occur for the entire time you take the medication. If SSRI side effects are bothering you, talk to your doctor about switching medications, or adjusting your dosage.
Common SSRI side effects include:
- Sleep issues
- Blurred vision
- Dry mouth
- Anxiety and agitation
- Joint and muscle pain
- Digestive upset:
- Sexual dysfunction
- Low sex drive
- Problems with erections
- Trouble orgasming
- Appetite changes
- Weight gain or weight loss due to change in appetite
You can reduce your chances of digestion upset and nausea by taking your SSRI medication with food; taking it before you go to sleep may also reduce the likelihood of nausea.
What Are The Safety Concerns With SSRIs
In most cases, it’s safe for you to take selective serotonin reuptake inhibitors to treat your depression or anxiety symptoms. However, as is the case with any medication, there are some safety concerns to keep in mind, and there are some people who should not take SSRIs.
For example, you might need to take precautions if:
You are pregnant
Certain antidepressants are not safe for pregnant women. This, however, doesn’t mean that you shouldn’t take antidepressants while you are pregnant. Talk to your doctor or psychiatrist about the risks and benefits of continuing to take antidepressants during pregnancy. Chances are, even if the current antidepressant you are taking isn’t safe, there is another one that is.
You are taking other medications
SSRI drugs can interact with other medications you are taking and produce uncomfortable or dangerous side effects. The same is true for any herbal supplements you may be taking. That’s why it’s important to disclose any and all medications and supplements to your doctor before starting antidepressants.
You are having suicidal thoughts
Though rare, SSRIs can trigger suicidal thoughts, especially in people younger than 25. If you are experiencing suicidal ideation, speak to your healthcare provider, therapist, or psychiatrist right away. If you are in immediate danger, seek emergency medical care.
You show signs of serotonin syndrome
Though rare, taking SSRI drugs can cause you to develop serotonin syndrome, which is when high levels of serotonin accumulate in your body. Usually this occurs when you are taking more than one medication that increases serotonin levels — for example, if you are taking an SSRI along with an herbal supplement such as St. John’s wort.
Signs of serotonin syndrome:
- Restlessness and tremors
- Changes in blood pressure
- Increased heart rate
If untreated, serotonin syndrome can be serious, so you should seek medical attention right away if you are taking an SSRI and experiencing these symptoms.
How Long Do SSRIs Take To Work?
When you are faced with depression or any other mental health struggle that requires medication, you want the medication to work right away so that you can feel better. This is understandable. However, you should keep in mind that SSRI drugs can take a few weeks to kick in.
Generally speaking, SSRIs take 4-6 weeks to work fully. In some cases it can take longer for them to reach their full effect. You should consult with your doctor if you are not noticing a change in your mood or depressive symptoms within 4-6 weeks.
How to Stop SSRI Treatment
In general, it is never wise to stop taking SSRI drugs abruptly. Doing so can cause withdrawal symptoms, otherwise known as discontinuation syndrome.
Some of the unpleasant side effects of discontinuation syndrome include:
- Feeling uneasy or “on edge”
- Nausea or stomach upset
- Feeling dizzy
- Feeling ill or having flu-like symptoms
Talk to your doctor or psychiatrist about how to slowly decrease your dosage of your SSRI so you will have minimal withdrawal symptoms.
Questions To Ask Your Doctor Or Psychiatrist
Deciding to take a selective serotonin reuptake inhibitor (SSRI) to help manage your depression can be a gamechanger, but it’s only something that you should do after careful consideration and in consultation with your doctor or psychiatrist.
As you consider taking an SSRI, some questions you might want to ask include:
- Should I continue therapy while I take the medication?
- How will I know if the medication is working?
- At what point should I stop taking the medication?
- What side effects should I watch out for?
- Are there certain over-the-counter medications to avoid while taking an SSRI?
- Can I drink alcohol while taking an SSRI?
You may also have your own specific questions and concerns. Remember, your concerns are valid and you should not hesitate to reach out to your healthcare provider if you have any questions before you begin taking an SSRI or while you are taking one. That’s what they are there for.