Selective serotonin reuptake inhibitors (SSRIs)
How It Works
Antidepressants improve mood by affecting
the levels of a chemical messenger in the brain (neurotransmitter) called serotonin.
start to feel better within 1 to 3 weeks of taking antidepressant medicine. But
it can take as many as 12 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. It is possible that one of the medicines will work
better for you than another. You may have to try several medicines before you
find the right one.
Why It Is Used
Antidepressants are used to relieve
obsessive thoughts and subsequent compulsive behaviors in those who have
obsessive-compulsive disorder (OCD).
How Well It Works
Research shows that certain
antidepressants improve symptoms of OCD and help balance brain chemicals.
For children and adolescents with
OCD, treatment combining
cognitive-behavioral therapy with antidepressants
(SSRIs), such as sertraline, works better than only taking medicine.
Cognitive-behavioral therapy alone also works well, but it works better if it
is combined with medicine.
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call 911 or other emergency services right away if you have:
Call your doctor if you have:
Common side effects of this medicine include:
See Drug Reference for a full list of side effects.
(Drug Reference is not available in all systems.)
The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.
What To Think About
Never suddenly stop taking antidepressants. The use of any
antidepressant should be tapered off slowly and only under the supervision of a
doctor. Abruptly stopping antidepressant medicine can cause negative side
effects or a relapse into a depressive episode or anxiety disorder.
If other mental health problems (such as
depression) are present along with OCD, other medicines (such as a mood
stabilizer or an antianxiety or antipsychotic medicine) also may be needed to
effectively treat the combined disorders.
SSRIs can be safer than tricyclic or tetracyclic
antidepressants, because they don't cause death if taken in large quantities
(overdose). SSRIs usually are well tolerated and effective. SSRIs also may be
safer for older adults, because the side effects are more tolerable.
People with liver
disease usually need lower doses of SSRIs.
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.
bleeding more likely in the upper gastrointestinal tract (stomach and
esophagus). Taking SSRIs with NSAIDs (such as Aleve or Advil) makes bleeding
even more likely. Taking medicines that control acid in the stomach may
SSRIs are also used to
treat depression. SSRIs alone aren't commonly used if you have episodes of
mania, such as in
Sexual dysfunction can be a
significant problem for some people while taking an SSRI. A medicine such as
sildenafil (Viagra) may help both men
and women who have sexual problems caused by SSRIs.2, 3
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
Women who take an SSRI during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating your anxiety disorder.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Abajo FJ, Garcia-Rodriguez LA (2008). Risk of upper
gastrointestinal tract bleeding associated with selective serotonin reuptake
inhibitors and venlafaxine therapy. Archives of General Psychiatry, 65(7): 795–803.
Nurnberg HG, et al. (2003). Treatment of
antidepressant-associated sexual dysfunction with sildenafil. JAMA, 289(1): 56–64.
Nurnberg GH, et al. (2008). Sildenafil treatment of
women with antidepressant-associated sexual dysfunction: A randomized
controlled trial. JAMA, 300(4): 395–404.
Primary Medical Reviewer
||Patrice Burgess, MD - Family Medicine
Specialist Medical Reviewer
||Lisa S. Weinstock, MD - Psychiatry
Current as of
||June 5, 2012