SSRI

Selective serotonin reuptake inhibitors are an antidepressants indicated in depression and anxiety.

Method Of Action

Depression and therefore SSRI action is not fully understood. There are a variety of theories on the neurophysiology of depression but one is that there's a lack of stimulation of neurons at the synapse. Serotonin is a neurotransmitter and SSRIs inhibit serotonin reuptake in the synaptic cleft, increasing stimulation of the post-synaptic neuron.

Indications

• Depression
• Anxiety - in the first 2 weeks, anxiety will increase with SSRI alone. So diazepam must be prescribed alongside
• Some personality disorders
• Premature ejaculation

The most important of these with regards to psychiatry are depression and, to lesser extent though still important anxiety. SSRIs are the first-line pharmocological treatment in both these conditions.

Contraindications

Drugs

• MAOIs - causes serotonin syndrome
• Tramadol - may produce seizures

Medical Conditions

• Hepatic impairment

Side effects

There is a large number of potential side-effects of SSRIs. However the main two are:

• GI upset
• Sexual dysfunction (including loss of libido)

Generic Names

• Fluoextine
• Citalopram
• Escitalopram
• Paroxetine
• Sertaline