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Types of SSRI’s

Types of SSRI’s

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs are one of the most widely prescribed types of antidepressants. They’re usually preferred over other antidepressants, as they cause far fewer side effects. An overdose is also less likely to be fatal.

Fluoxetine is probably the best-known SSRI (sold under the brand name Prozac). Other SSRIs include citalopram (Cipramil), paroxetine (Seroxat) and sertraline (Lustral).

Serotonin-noradrenaline reuptake inhibitors (SNRIs)

SNRIs are similar to SSRIs. They were designed to be a much more effective antidepressant than an SSRIs. However, the evidence that SNRIs are more effective in treating depression is still uncertain. It seems that some people respond better to SSRIs, while others respond better to SNRIs.

Examples of SNRIs include duloxetine (Cymbalta and Yentreve) and venlafaxine (Efexor).

Noradrenaline and specific serotonergic antidepressants (NASSAs)

NASSAs may be effective for some people who are unable to take SSRIs. The side effects of NASSAs are similar to those of SSRIs, but they’re thought to cause fewer sexual problems (ED, Libido etc). However, they may also cause more drowsiness at first.

The main NASSA prescribed in the UK is mirtazapine (Zispin).

Tricyclic antidepressants (TCAs)

TCAs are an older type of antidepressant. They’re no longer usually recommended as the initial treatment for depression because they can be more dangerous if an overdose is taken. They also cause more unpleasant side effects than SSRIs and SNRIs.

Exceptions are sometimes made for people with severe depression that fails to respond to other treatments. TCAs may also be recommended for other mental health conditions, such as OCD and Bipolar Disorder.

Examples of TCAs include amitriptyline (Tryptizol), Clomipramine (Anafranil), Imipramine (Tofranil), lofepramine (Gamanil) and Nortriptyline (Allegron).

Some types of TCAs, such as Amitriptyline, can also be used to treat chronic nerve pain.

Monoamine oxidase inhibitors (MAOIs)

MAOIs are an older type of antidepressant that is rarely used nowadays.

They can cause potentially serious side effects so should only be prescribed by a specialist doctor.

Examples of MAOIs include tranylcypromine, phenelzine and isocarboxazid.

Other treatments for depression include talking therapies such as cognitive behavioural therapy (CBT). Increasingly, people with moderate to severe depression are treated using a combination of antidepressants and CBT. Antidepressants work quickly in reducing symptoms, whereas CBT takes time to deal with causes of depression and ways of overcoming it.Regular exercise has also been shown to be beneficial for those with mild depression.

Types of SSRIs

The FDA is in charge of deciding which medications are safe and effective for which reasons. The following SSRIs are approved to treat depression, anxiety, and other mood disorders:

  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Fluvoxamine (Luvox, Luvox CR)
  • Paroxetine (Paxil, Paxil CR)
  • Sertraline (Zoloft)
  • Vilazodone (Viibryd)

    Side Effects

    Most people who use SSRI antidepressants don’t have major problems, but every kind of medical treatment carries some risk. The possible side effects of these antidepressants include:

    • Insomnia
    • Headaches
    • Rash
    • Blurred vision
    • Drowsiness
    • Dry mouth
    • Agitation or nervousness
    • Feeling dizzy
    • Pain in the joints or muscles
    • Upset stomach, nausea, or diarrhoea
    • Reduced sexual desire
    • Problems with erection or ejaculation

    Some people, especially children and young adults, may be more likely to have suicidal thoughts when they take SSRIs. Studies have shown that when compared to results from taking a placebo, chances of having suicidal thoughts doubled — from between 1% and 2% to between 2% and 4% — when taking any kind of antidepressant, including an SSRI. If you have thoughts of hurting yourself while taking an SSRI, call 911. ( UK call 999).

    There are also important safety issues to consider about SSRIs. Although it’s rare, if too much serotonin accumulates in your system, you can develop a condition called serotonin syndrome. This happens most often if two different medications that increase serotonin are combined.

    SSRIs can also have dangerous interactions with some medicines, both prescription and over-the-counter, including some herbs and supplements. Before starting on a course of SSRIs, make sure to tell your doctor all the different kinds of medications and supplements you’re taking.

    Since all SSRIs work in a similar way, the side effects tend to be similar no matter what kind you take. But each SSRI has a different chemical makeup, so it’s possible that if you’re having side effects from one, you may not experience as many or any at all if you switch to another.

    While some people do have side effects, others do not, and in many cases, the side effects disappear after a few weeks of treatment. It’s important to work with your doctor to find a medication that’s right for you.

    How Long Do SSRIs Take to Work?

    Everyone is different when it comes to seeing improvements on SSRIs. But people typically start noticing positive changes after about 4 to 6 weeks of treatment. It can take several months to feel the full effect of the medication.

    But if you’re not feeling any improvements after about 6 to 8 weeks, talk to your doctor about trying another treatment or adjusting your dosage.

    Stopping Treatment

    Even though SSRIs aren’t habit-forming, it can be dangerous to stop them suddenly or miss several doses in a row. Doing this can lead to a condition called discontinuation syndrome that causes withdrawal-like symptoms.

    If you do experience discontinuation syndrome, you might start to feel like you have the flu and/or notice symptoms like:

    • Nausea
    • Dizziness
    • Uneasiness
    • Fatigue or lethargy

    That’s why it’s important to work up to your prescribed dosage slowly with the help of your doctor and to step down gradually if you agree it’s time to stop.

     

     

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