Bipolar Disorder: Selective Serotonin Reuptake Inhibitors (SSRIs) for Bipolar Disorder

Your doctor may prescribe newer antidepressants known as SSRIs (selective serotonin reuptake inhibitors) for treating severe depression in bipolar disorder. They are usually prescribed along with lithium.

SSRIs are believed to work by boosting levels of the brain chemical serotonin.

This class of antidepressants includes:

• Paxil (paroxetine)
• Prozac (fluoxetine)
• Luvox (fluozamine)
• Zoloft (sertraline)

Most antidepressants take several weeks to start working. Though the first one that is prescribed works in the majority of people, others may need to try two or three to find the right one. Your doctor may also prescribe a sedative to help relieve anxiety, agitation, or sleep problems while the antidepressant begins to work.

SSRI Side Effects

Side effects of SSRIs are generally milder than those of the older classes of antidepressants. Studies indicate some people taking SSRIs developed painful headaches and tooth grinding. Their symptoms went away with the addition of the anti-anxiety drug Buspar (buspirone).

Common side effects may include:

• Nausea
• Nervousness
• Insomnia
• Diarrhea
• Rash
• Agitation
• Erectile dysfunction
• Loss of libido
• Weight gain or loss

The Food and Drug Administration (FDA) recommends close observation of people treated with these medications for worsening depression or the emergence of suicidal tendencies. It is unclear whether antidepressants contribute to the emergence of suicidal thinking and behavior. However, the FDA indicates a need for careful monitoring of patients being treated with these drugs -- especially at the beginning of therapy and during dose changes.

Reviewed by the doctors at The Cleveland Clinic Department of Psychiatry and Psychology.