Health Library Selective Serotonin Reuptake Inhibitors (SSRIs) for DepressionFrom Healthwise

Symptoms of depression result from an imbalance of certain brain chemicals ( neurotransmitters). Selective serotonin reuptake inhibitors (SSRIs) relieve symptoms of depression by increasing the amount of serotonin available.

Selective serotonin reuptake inhibitors are as effective in treating depression as other types of antidepressants, such as tricyclic antidepressants and MAOIs, but they have different and often less severe side effects.

SSRIs have become one of the first treatments that are tried for depression because they have proven effective and have few side effects.

SSRIs relieve depression in most people who take these medications.¹

Side effects of selective serotonin reuptake inhibitors include:

• Nausea, loss of appetite, or diarrhea.
• Anxiety or irritability.
• Problems sleeping or drowsiness.
• Loss of sexual desire or ability.
• Headaches or dizziness.
• Weight gain.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

FDA Advisories. The U.S. Food and Drug Administration (FDA) has issued:

• An advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when doses are changed.
• A warning about the antidepressants Paxil and Paxil CR and birth defects. Taking these medicines in the first 12 weeks of pregnancy may increase your chance of having a baby with a birth defect.
• A warning about taking triptans, used for headaches, with SSRIs (selective serotonin reuptake inhibitors) or SNRIs (selective serotonin/norepinephrine reuptake inhibitors). Taking these medicines together can cause a very rare but serious condition called serotonin syndrome.

You may start to feel better within 1 to 3 weeks of taking selective serotonin reuptake inhibitors (SSRIs). But it can take as many as 6 to 8 weeks to see more improvement. If you have questions or concerns about your medicines, or if you do not notice any improvement by 3 weeks, talk to your doctor.

SSRIs may be safer than tricyclic antidepressants because they do not cause death if taken in large quantities (overdose).

Sexual dysfunction can be a significant problem for some people while taking an SSRI. Other antidepressants such as bupropion (Wellbutrin) may be less likely to cause significant sexual dysfunction as a side effect and may be used instead of, or in addition to, an SSRI.

Studies have found that daily use of SSRIs may increase the risk of bone fracture in adults over age 50. Talk to your doctor about this risk before taking an SSRI.²

Sexual problems in men resulting from use of SSRIs may also be alleviated by use of an erectile dysfunction medication such as sildenafil citrate (Viagra).³

Never suddenly stop taking antidepressants. If you decide to stop taking your antidepressant, you will need to lower your dose slowly, with your doctor's help. Abruptly stopping antidepressant medications can cause negative side effects or a relapse into another depressive episode.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Citations

1. Butler R, et al. (2005). Depressive disorders, search date September 2004. Online version of Clinical Evidence (14): 1–41.

2. Richards JB, et al. (2007). Effect of selective serotonin reuptake inhibitors on the risk of fracture. Archives of Internal Medicine, 167(2): 188–194.

3. Nurnberg HG, et al. (2003). Treatment of antidepressant-associated sexual dysfunction with sildenafil. JAMA, 289(1): 56–64.

Author:	Jeannette Curtis Ralph Poore	Last Updated: March 21, 2007
Medical Review:	Martin Gabica, MD - Family Medicine Lisa S. Weinstock, MD - Psychiatry
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