Is a SSRI some kind of clandestine military weapon that the Pentagon keeps super top secret?
Uh, no …
A selective serotonin reuptake inhibitor has nothing to do with the military, but this medication is a weapon against psychological maladies like depression that some 16.2 million Americans or 6.7% of the population suffer from with at least one depressive episode in a given year.
How Do SSRIs Work?
SSRIs act as neuron transmitters to alter the brain chemistry and improve a person’s mood. By increasing serotonin levels, SSRI medications help relieve depressive and other mental health symptoms.
Serotonin reuptake is a process by which neurotransmitters are recycled from the synaptic cleft. The neurotransmitter serotonin acts as a chemical messenger, passing signals between nerve cells in your brain and throughout your body. When an SSRI inhibits this recycling of serotonin, the latter stays active longer within the synapse to continue sending messages and regulating your mood.
An effective antidepressant should be working on different levels – not just one specific area – so that you can address symptoms like sleep disturbances or anxiety that sometimes accompany depression and other mental health issues. In general, these medications work significantly better than placebos when taken correctly at proper dosages over time.
SSRIs usually take two to four weeks to start working but sometimes it can take up to eight weeks for people to feel the full effects of the medication.
History of SSRIs
SSRIs were developed in the late 1980s. The first SSRI, Fluoxetine (Prozac), became available to the public in 1988. It is manufactured by Eli Lilly and Company. SSRIs are currently some of the most commonly prescribed medications in the world with over 350 million prescriptions written for them each year. They are used to treat a variety of psychiatric disorders, including depression, anxiety disorders, obsessive compulsive disorder (OCD) and eating disorders.
There are many different types of SSRIs on the market today including:
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Paroxetine (Paxil)
- Vilazodone (Viibryd)
SSRI Generations
In addition to the newest SSRIs, there are also a number of early ones that have been used for many years. They include meds like Sertraline (Zoloft). These drugs all work similarly in inhibiting serotonin reuptake, but they differ slightly from each other as well as from later medications.
These first generation antidepressants were much more specific than current medication which can treat several mental health problems at once such as anxiety alongside depression or bipolar disorder along with ADHD symptoms. This is because it was believed that different types of disorders were caused by different levels of serotonin.
The latest SSRI medications are called second generation antidepressants and include Duloxetine (Cymbalta), Mirtazapine (Remeron), Venlafaxine (Effexor) and Bupropion (Wellbutrin).
These medications are more efficacious than the early ones in that they work on multiple neurotransmitters such as serotonin, norepinephrine and dopamine. They generally are able to treat a wider range of mental health disorders.
For example, Cymbalta is used for treating pain along with depression, anxiety or stress. Remeron is often prescribed for insomnia along with depression or anxiety. Effexor can be used to treat anxiety and depression while Wellbutrin is more specifically prescribed for ADHD symptoms along with some forms of depression.
Latest SSRIs
There are also a number of medications that have been researched over the years but not yet approved by the Food and Drug Administration (FDA). These include Vortioxetine (Brintellix), Vilazodone (Viibryd) and Milnacipran (Ixel).
These drugs, like the second generation SSRIs, treat co-occurring mental health issues. For example, in addition to treating depressive episodes, Brintellix can additionally be used to treat generalized anxiety disorder where Viibryd may be if your doctor thinks you do not respond as well to SSRIs.
SSRI Side Effects
SSRIs are one of the most commonly prescribed medications in the United States and they are considered safe and effective when used as prescribed. However, like all medications, there is always some risk associated with taking them.
It is important to be aware of the potential side effects before starting treatment and to report any concerns or problems you experience while taking SSRIs to your healthcare provider.
The most common side effects of SSRI medications include:
- Nausea
- Diarrhea
- Vomiting
- Dry mouth
- Loss of appetite
- Weight changes
- Sexual problems (such as decreased sex drive or difficulty achieving orgasm)
- Sleep problems (insomnia)
- Headaches
SSRIs can interfere with other medications you are taking, either prescription or over the counter drugs. In very rare cases, serotonin syndrome can occur. This is a rare condition that occurs from too much serotonin in your system at once and causes symptoms such as fever, sweating, confusion and even death in extremely rare cases. It’s helpful to be aware of any potential interactions between SSRIs and supplements and/or herbs you might be taking.
SSRI Best Practices
If you are currently taking an SSRI, there are some things you can do to help ensure that it works as well as possible for you:
- Take your medication every day at the same time and in the same way (e.g. with or without food).
- Talk to your doctor if you experience any bothersome side effects. They may be able to adjust your dose or prescribe a different medication.
- Keep track of how you’re feeling – both physically and emotionally – and report any changes to your doctor. Keep a journal! This information can help them determine whether the dosage is correct and whether the antidepressant is still effective for you.
- Continue the medication even after symptoms have improved. Most people need to take antidepressants for six to nine months, and sometimes longer.
Avoid Mixing SSRIs with Alcohol
SSRIs are not addictive, but they can be habit-forming. Do not mix them with alcohol or other drugs that make you drowsy. Taking SSRIs with these substances can increase your risk of side effects, such as dizziness and falls, a problem for older patients. Do not drive or operate heavy machinery or tools when taking an SSRI.
If you do experience adverse side effects while taking SSRIs, be sure to report them to your healthcare provider. With careful monitoring, most people tolerate these medications well and find that they help improve their mood and quality of life.
Stopping SSRIs
Abruptly stopping SSRI intake or skipping doses for a prolonged period of time can be dangerous, leading to unpleasant withdrawal symptoms such as nausea, headache and fatigue among other issues that may require immediate medical attention.
Even when discontinuing SSRI use slowly under medical supervision, most patients do not experience any significant problems. Your physician can help guide you on how to safely stop using these medications, if needed.
SSRIs are not a top secret weapon, but a critical component of a mental health regime to regulate moods and improve your quality of life. If you have questions or would like to describe how SSRIs helped you, leave a comment below!