SSRIs stand for selective serotonin reuptake inhibitors. They are the most commonly prescribed class of medications for mental health and treat a variety of disorders including:

  • Depression (major depressive disorder, MDD)
  • Generalized anxiety disorder
  • Social anxiety
  • Panic disorder
  • Specific phobias
  • Obsessive-compulsive disorder (OCD)
  • Premenstrual dysphoric disorder
  • Post-traumatic stress disorder (PTSD)
  • Impulsivity

SSRIs work by increasing the amount of serotonin accessible to the neurons in the brain and gastrointestinal system. Common SSRIs include:

  • Citalopram (Celexa): 20-40mg
  • Escitalopram (Lexapro): 10-30mg
  • Fluoxetine (Prozac): 20-100mg
  • Fluvoxamine (Luvox): 50-300mg, often dosed 2x/day
  • Paroxetine (Paxil CR): 25-62.5mg
  • Sertraline (Zoloft): 25-300mg

SSRIs are considered “first line” when treating depression and anxiety in adults since they have fewer side effects than most other classes of antidepressants and are very effective in most people. SSRIs, like almost all antidepressants, take several weeks to start working. Typically, this is a gradual response that slowly reduces the “volume” of symptoms over time.

The most common side effects of SSRIs are typically transient and, if they occur, resolve after taking the medication for several days to weeks. These include:

  • Upset stomach
  • Nausea
  • Insomnia
  • Headaches
  • Apathy
  • Sexual side effects (libido and difficulty with orgasms)

Rare side effects include:

  • Bleeding
  • Stomach bleeding when combined with frequent use of NSAIDs
  • Geriatric patients have to watch for rare issues with low sodium and decreased platelet activity
  • Suicidal thoughts
  • Stopping an SSRI requires a taper. If you stop abruptly, there is a chance of flu-like symptoms. Some people may require an extensive taper due to sensitivity when stopping an SSRI. Fortunately, this is rare.