What Is An SSRI Drug (Antidepressant)?
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Depression symptoms may be managed with medications, and selective serotonin reuptake inhibitors (SSRIs) are one of the most commonly prescribed classes for this condition. SSRIs may be prescribed by doctors to increase serotonin levels in the brain and reduce symptoms of anxiety and depression. A person experiencing depression usually has alterations with a common neurotransmitter, like dopamine or serotonin.
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Depression chemicals
Neurotransmitters work by sending messages to neurons within the brain, causing a reaction within the body. While there are many different neurotransmitters, serotonin and dopamine have been commonly linked to depression. When there aren't enough neurotransmitter chemicals, it can create breaks in the messages passed between neurons, so the brain doesn't always have the right response.
Depression is often referred to as a chemical imbalance in the brain. However, researchers now believe it’s more complex than a simple deficit of a chemical. Scientists are still trying to understand exactly how the interactions of chemicals create symptoms.
Researchers know that the brain produces both inhibitory and excitatory neurotransmitters, and serotonin is one of those inhibitory chemicals and the primary target of SSRI drugs.
What is an SSRI?
Those living with depression may find medication helpful for reducing symptoms, and SSRIs are some of the most common medications prescribed. However, providers often recommend individuals try medication alongside therapy, as the relief from medication sometimes persists only while taking the medication and may not work for everyone’s situation. SSRIs are specific to serotonin, inspiring the name "selective." Researchers have various theories about the mechanism of serotonin and depression.
When the brain releases neurotransmitters, they are either diffused, broken down by enzymes, or reabsorbed (a process called reuptake). One theory is that when the receptors are blocked from re-uptaking serotonin, it stays in the gap between neurons for longer, affecting communication and causing symptoms of depression. SSRIs work primarily on the neurotransmitter serotonin to keep it available in the synapse between neurons.
Types of SSRI antidepressants
There are various SSRIs available, and choosing the best option for treatment may involve trial and error because there's no way to test for levels within the brain correctly. Each person has a different chemical makeup, which is why one SSRI for anxiety may work for one person but not for another.
The U.S. Food and Drug Administration (FDA) controls SSRI drugs and has a list of those approved to treat depression. Talk to your doctor about which medication is right for you.
Medications can cause side effects and interactions. For this reason, tell your doctor about any other prescription or over-the-counter medications, supplements, or herbal remedies you take. Medications for depression are often prescribed together to be taken in combination to get the best results.
SSRI dosage
SSRI drugs often take several weeks to work. If you don’t experience any improvement after several weeks, consider talking to your doctor again. It can take four to eight weeks before the full effect is felt. Doctors may prescribe the lowest possible dose to start and increase the dose as necessary.
If an SSRI is working, your doctor may tell you to continue taking it for at least six months to two years. Do not skip doses, and take the medication as ordered by your provider. Do not start, stop, or change a medication without consulting your prescribing physician.
Stopping SSRIs abruptly can lead to withdrawal effects. These may resemble the flu, but they can also include sensations that some people refer to as “brain zaps,” often causing the sensation of an electric shock.
It is possible to overdose on SSRI medications, although this is much less likely and less dangerous than an overdose with older monoamine oxidase inhibitors (MAOI), a type of antidepressants that was more often used in the past. A large, single overdose of SSRI medication can be toxic, causing an abnormal heart rate or even coma. If you have taken a large amount of your medication, contact the poison control center and your prescribing provider immediately.
How can I get SSRIs?
SSRIs, such as citalopram (Celexa), are prescription drugs, which means they can only be prescribed by a doctor. While most doctors can prescribe these medications, psychiatrists may be more commonly consulted, as they work with mental health medications. Psychologists cannot prescribe medication in most states.
A doctor may ask if you've tried other avenues to manage your depression, such as exercise or therapy. They may also ask about temporary situations in your life causing emotional difficulties. If you're not yet working with a therapist for your depression and it's serious enough that you think medication would help, consider reaching out and finding a therapist who has experience treating depression. Therapy alongside psychiatric support is often effective in reducing long-term symptoms.
Are there side effects of SSRI medications?
One of the reasons some people with depression choose not to take medication or decide to stop their medication are the associated side effects. Side effects often aren't permanent, but in some instances, they can worsen the depression itself.
Not all people experience side effects, and they can vary between people. Some of the most commonly experienced side effects include the following:
Constipation or diarrhea
Drowsiness or insomnia
Dizziness and blurred vision
Headaches
Loss of appetite and nausea
Anxiety
Sexual dysfunction
Some people experience more severe symptoms, including manic behavior, suicidal thoughts, chest pain, hives, or another allergic reaction. Children and young adults may be more likely to experience thoughts of suicide, which is why SSRIs are less often prescribed to this population.
If you are experiencing suicidal thoughts or urges, contact the National Suicide Prevention Lifeline at 988. Support is available 24/7.
With SSRIs, it is also possible to have a rare side effect called serotonin syndrome, where too much serotonin builds up in the body. Serotonin syndrome can be deadly, and the symptoms may include confusion, headaches, diarrhea, palpitations, tremors, twitching, shivering, and more. If symptoms of serotonin syndrome are ignored, they can progress to unconsciousness, seizures, fever, and erratic heartbeat. The risk of serotonin syndrome may be higher if you're taking more than one serotonergic medication at a time and when you first start taking them. Serotonin syndrome may also occur if you take an SSRI with St. John's Wort, an herbal supplement. Serotonin syndrome can be a serious condition that requires hospitalization and may be fatal.
Combination therapy
Some people find that a combination of medication and therapy aids their depression symptoms. Numerous studies have demonstrated the effectiveness of online therapy for several mental disorders, including major depressive disorder, panic disorder, binge-eating disorder, and obsessive-compulsive disorder (OCD). A meta-analysis published in World Psychiatry found that anti-depressant medications plus therapy, also known as combination therapy, can have a significantly more positive result for treating depression than medication alone.
If your depression symptoms make it difficult to leave home for therapy, you might consider online therapy, which research has shown to be just as effective as in-office therapy for depression. With a platform like BetterHelp, you can schedule therapy from the comfort of your home and communicate with your therapist via audio, live chat, or videoconferencing. Also, BetterHelp allows you to message your therapist at any time through in-app messaging, and they’ll respond as soon as they can. This feature may be useful if you experience depression or anxiety in between sessions.
Takeaway
While there is some debate about the effectiveness of selective serotonin reuptake inhibitors (SSRIs), they may support some people with their symptoms of depression. If you’re experiencing symptoms of depression, you may benefit from talking to a doctor about taking an SSRI. You might also consider trying therapy, whether traditional in-office therapy or online therapy. With an online therapy service, you can be matched with a licensed therapist who has experience treating depression.
Frequently asked questions
Read more below for answers to questions commonly asked about this topic.
What medications are considered SSRIs?
SSRIs, or selective serotonin reuptake inhibitors, are a type of antidepressant medications commonly prescribed to help individuals experiencing moderate to severe depression and anxiety, among others. The Food and Drug Administration (FDA) recognizes seven different medications that qualify as SSRIs. These commonly prescribed antidepressants may decrease symptoms of various mental health conditions, like depression and anxiety.
What exactly do SSRIs do?
Neurotransmitters are chemicals that send messages between nerve cells (neurons) in the brain. After a neurotransmitter like serotonin is used to send a message to nearby nerve cells, it’s either diffused, broken down by enzymes, or reabsorbed. When this process causes a lack of adequate serotonin levels, researchers theorize this may result in symptoms of depression. SSRIs work by blocking serotonin reuptake or reabsorption, thereby making it more available for use by the brain.
Is anti-anxiety an SSRI?
SSRIs, or selective serotonin reuptake inhibitors, are one of the anti-anxiety medications available. Medication is not prescribed for every individual who experiences an anxiety disorder, but it can be helpful in some cases. Speak to your doctor or psychiatrist if you’re interested in learning more about SSRIs for anxiety.
What are the long-term side effects of SSRIs?
Some of the potential long-term side effects of SSRIs that a person could experience include insomnia, skin rashes, joint and muscle pain, and sexual dysfunction, among others. These medications may also slightly increase the risk of internal bleeding, particularly if the individual is taking aspirin, ibuprofen, or similar medications concurrently.
Speak with your doctor or psychiatrist before starting, stopping, or changing any medication. Some people experience antidepressant discontinuation syndrome and other potentially harmful effects if they stop or alter their dose too quickly.
Why are SSRIs the best?
SSRIs are a type of medication commonly prescribed to help treat symptoms of depression, anxiety, and other mental health conditions. While they may help some people manage their symptoms, they may not be suitable for everyone. There is not necessarily a one-size-fits-all treatment program for each mental health disorder. For that reason, individuals can speak to their doctor or mental health care provider about what treatment plan may be right for their unique circumstances and whether treatment with an antidepressant could be a feasible option.
What is the safest antidepressant?
Although the federally approved medications to treat depression have been widely tested and are generally considered to be safe, all medications come with some amount of risk. Individual results may vary. Antidepressants include selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors, and serotonin and norepinephrine reuptake inhibitors, among other medications.
How do you know if you need antidepressants?
Meeting with a doctor or mental health specialist to discuss your symptoms, circumstances, and options for treatment is often the most effective way to know if you may benefit from taking SSRIs or other types of antidepressant medications.
You can also discuss any side effects you experience and ask about alternative medications if one antidepressant doesn’t work for you.
What is the safest and most effective antidepressant?
The antidepressants approved by the Food and Drug Administration (FDA) have been thoroughly tested and deemed to be generally safe for the average person. Each SSRI has its own properties, and different medications within the SSRI class may be best for different people. However, they’re not right for everyone, and all medications come with some risk. Remember to consult with your doctor or psychiatrist before stopping, starting, or changing any medication, as individual results can vary.
What not to take with SSRI?
Potential drug-drug interactions are one reason to potentially not take an SSRI. These medications should generally not be taken with SSRIs because of the risk of harmful or even fatal interactions. When working with your prescribing provider, ask what medications may interact with your unique SSRI. If you have an allergy to the SSRI or any of its ingredients, you should not take it, and you should use caution if you are considering taking other SSRI medications.
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