SSRIs as Antidepressants for Depression

Treating depression is a challenge. And for most people with depression, doctors often prescribe a type of medication called selective serotonin reuptake inhibitors, or SSRIs. These are a type of antidepressant that work by increasing levels of serotonin in the brain.

Compared to older antidepressants, SSRIs are generally safer and cause fewer side effects, making them a popular choice for many people. But, there are concerns about best practices when using antidepressants.

Let’s explore how SSRIs work, the benefits they provide, and what to expect when SSRIs are included as part of a depression treatment plan to help you understand why they’re often the go-to option for managing depression.

What are SSRIs?

Selective Serotonin Reuptake Inhibitors (SSRIs) are one of the most common antidepressant medications used to treat depression as well as a host of other mental health conditions.

They’ve quickly become one of the most commonly prescribed treatments because they are effective, easy to use, and cause far fewer side effects than the earlier formulas for this and similar medications. But what are they, and how do they work?

Serotonin and Depression

To understand how SSRIs work, let’s first learn about serotonin. Serotonin is a neurotransmitter released in the brain – think of it as a little messenger that helps brain cells communicate with each other. It plays an important role in regulating mood, emotions, sleep, and even appetite. When serotonin levels are low, a person experiences feelings of sadness and anxiety, among other symptoms of depression.

Now, the “reuptake” part of an SSRI’s name refers to a process where the brain reabsorbs serotonin after it has delivered its message. This reabsorption, or reuptake, reduces the amount of serotonin available for communication between brain cells. SSRIs work by blocking this process, leaving more serotonin available in the brain.

By increasing serotonin levels, SSRIs help improve mood, reduce anxiety, and alleviate other symptoms of depression. Be aware that taking SSRIs won’t lead to an instant fix – it may take a few weeks to start feeling the effects, but for many, this depression medication makes a significant difference over time. Consult your healthcare professional before and during any course of SSRIs to ensure you’re on the right track.

One of the main reasons SSRIs are so widely used is that they tend to have milder side effects than other antidepressant medications. Drugs like tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) cause more severe side effects like weight gain, drowsiness, or dangerous interactions with certain foods and other medications.

SSRIs have become a go-to option for treating depression and anxiety because they are effective, easy to use, and have a superior safety profile to TCAs and MAOIs. While SSRIs are not a cure, they are a potent drug that helps people manage their symptoms and start feeling more like themselves again. ^[1]

Common Types of SSRIs

Finding the right antidepressant to treat depression is tricky. With so many available, it’s often challenging to know which one to choose or which is the best SSRI for depression. Let’s take a closer look at five of the most common SSRIs and see how they are used, their effects, and what makes them different.

• Fluoxetine (Prozac): Fluoxetine, often prescribed under the brand name Prozac, is an SSRI that is widely used to treat depression. It is one of the earliest and most well-known SSRIs, and is administered for the treatment of depression, anxiety disorders, obsessive-compulsive disorder (OCD), and several other mental health conditions. It has a stimulating effect, which is helpful for those who feel tired and sluggish because of depression, and is also long-lasting, meaning it stays in the system for a while even when a dose is missed.
• Sertraline (Zoloft): Sertraline, also known as Zoloft, is one of the most common and effective SSRIs. It is a versatile drug used to treat several mental health conditions including depression, anxiety, panic disorders, and post-traumatic stress disorder (PTSD). It has a balanced effect and has fewer side effects, making it a good option for many people. While it may take a few weeks to notice improvements, it’s effective in lifting mood and managing anxiety.
• Escitalopram (Lexapro): Escitalopram is sold under the name Lexapro and is one of the newer SSRIs known for its effectiveness while producing relatively low side effects. It’s used to treat depression and generalized anxiety disorder (GAD). Many people find that it’s less likely to cause weight gain and drowsiness compared to other SSRIs. It’s seen as a gentler SSRI that represents a good starting point for a patient’s treatment.
• Citalopram (Celexa): Citalopram, or Celexa, is another SSRI prescribed to treat depression. It has a more calming effect, which is helpful for people who experience anxiety as well as depression. But, it’s important to follow the right dose, as taking too much can affect the heart.
• Paroxetine (Paxil): Paroxetine, or Paxil, is prescribed for depression, anxiety, and panic disorders. It’s effective but may come with a few adverse effects, like weight gain and drowsiness. Paroxetine is particularly helpful in treating severe anxiety or social phobia.

It’s important to remember that each of these SSRIs works slightly differently. Only a doctor or other qualified mental health professional can help you choose the SSRI that’s best for your specific needs and symptoms. While they are not a cure for depression, they are a powerful tool in managing depression, anxiety, mood disorders, and personality disorders. ^[2]

How Effective are SSRIs for Treating Depression?

Selective serotonin reuptake inhibitors are one of the most popular choices for treating depression because of their effectiveness. But just how well do they perform when it comes to managing the symptoms of depression?

According to a review published by the Journal of the American Medical Association, studies show that SSRIs can significantly reduce depression symptoms for the majority of people who take them. In their study, they found that around 60 – 70% of people experienced noticeable improvements in their mood, energy levels, and ability to function in daily life. ^[3]

SSRIs also often help in treating depression-related concerns such as anxiety, sleep problems, and difficulty concentrating. By addressing the symptoms of depression, SSRIs enable sufferers to enjoy a better quality of life. But it’s important to understand that they don’t work well for everyone, and it might take a few weeks of treatment to see the full effects.

SSRIs vs. Other Antidepressants

One of the main reasons SSRIs are seen as a first-line treatment of depression is that they cause fewer side effects and tend to be more effective compared to other classes of antidepressant medications. Here’s how they compare to a few other common options:

SSRIs vs. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs work on both serotonin and another brain chemical called norepinephrine. This makes them more stimulating than other neurotransmitters, which is particularly helpful for people dealing with fatigue. But, SNRIs also have stronger side effects, like nausea and sweating, causing SSRIs to be the more popular treatment option.

SSRIs vs. Tricyclic Antidepressants (TCAs)

TCAs are older antidepressant medications and are also effective in treating depression and its symptoms. But, they come with more intense side effects that include weight gain, drowsiness, and dry mouth. They’re no longer considered the first choice because of these drawbacks.
SSRIs stand out as a good balance between effectiveness and tolerability. While they are not perfect, they have helped millions of people across the globe manage their depression and regain a sense of control over their lives. If SSRIs don’t work or cause too many unpleasant side effects, other options like SNRIs and TCAs can be considered.

Side Effects of SSRIs

All medications have side effects, and SSRIs are no different. Understanding these side effects and knowing what to expect is important.

Common Side Effects

There is some good news: most people handle SSRIs well. Any side effects that do come up are usually mild, especially when they are first taken. Some of the common side effects of SSRIs are:

• Nausea
• Headaches
• Insomnia or drowsiness
• Reduced sex drive
• Dry mouth
• Weight changes (gains or loss)

For most SSRI users, these side effects will improve over time as their bodies get used to the medication. Doctors can also make adjustments to the dosage to help manage and minimize side effects.

Rare but Serious Side Effects

In some cases, SSRIs can cause more serious side effects that need immediate medical attention:

• Suicidal Thoughts: In some cases, SSRIs can increase suicidal thoughts and feelings.
• Serotonin Syndrome: This happens when serotonin levels get too high, usually from mixing SSRIs with other medications. Symptoms of Serotonin Syndrome include confusion, a rapid heart rate, fever, and muscle stiffness.
• Allergic Reactions: Swelling, rashes, trouble breathing, or any other negative reaction to SSRI consumption requires urgent and immediate medical attention.

If someone starts experiencing any side effects, the first thing to do is consult a medical professional. Doctors can help adjust the dosage, suggest ways to cope, or even switch to a different SSRI or antidepressant medication. You shouldn’t start or stop a course of SSRIs without your doctor’s guidance. ^[4]

What to Consider Before Starting SSRI Treatment

Before taking SSRIs for depression, it’s important to discuss a few things with a doctor or healthcare provider. This will help ensure the SSRI is safe and effective. Here’s what should be considered:

1. Medical History

Doctors need to know about any other health conditions, including:

• Bipolar disorder: SSRIs could trigger manic episodes
• Liver or kidney problems: They could affect how the body processes SSRIs
• Epilepsy or seizures: SSRIs lower the seizure threshold
• Bleeding disorders: SSRIs increase the risk of bleeding
• Glaucoma: SSRIs worsen eye pressure.

2. Current Medications and Supplements

Over-the-counter medications, prescription drugs, and herbal supplements can affect the efficacy of SSRIs. Doctors need to be informed if you are taking any of the following medications:

• Blood thinners like aspirin and warfarin
• Pain relievers like ibuprofen
• Other antidepressants and mood stabilizers
• St. John’s Wort

3. Understand Potential Interactions

SSRIs can interact with certain foods, activities, and other drugs. It is important to ask the doctor about any specific things that should be avoided while taking SSRIs.

4. Pregnancy or Breastfeeding

SSRIs have special considerations when pregnant or breastfeeding.

Alternatives to SSRIs

Depression affects people in different ways, and so too do the medications prescribed to treat the symptoms and manage the effects of depression. If SSRIs are not working, there are a few other alternatives to try:

Other Antidepressants

Here are a few other options:

• SNRIs: These work by increasing levels of both serotonin and norepinephrine to improve mood and the physical symptoms of depression.
• Bupropion: These are atypical antidepressants that target the brain chemical dopamine to boost energy and focus.
• TCAs and MAOIs: These are used when newer medications don’t work but have more side effects.

Non-Medication Approaches

Sometimes, a different approach – one that doesn’t rely on medication can make a difference in treating the symptoms of depression. Here are a few of these options:

• Psychotherapy: Therapies like Cognitive Behavior Therapy (CBT) can help manage negative thoughts, develop coping skills, and improve overall well-being.
• Lifestyle Changes: Exercise, diet, and getting enough sleep can make a difference in managing the symptoms of depression.
• Mindfulness: Techniques like meditation, yoga, and deep breathing can lower stress and boost mood.
• Support Groups: Connecting with others who understand depression and its symptoms can provide comfort and a few valuable insights.

If one treatment doesn’t work, there are other options to try. Working closely with a doctor to find the best approach is a great idea. ^[3]

SSRIs: Final Thoughts

SSRIs are incredibly helpful in treating depression. And while there are certain side effects to consider, they are still among the most commonly prescribed medications used to treat and manage depression. Understand the side effects, know what other options are available, and conduct a full review of your medical history alongside your healthcare provider to ensure the best treatment option is chosen.