SSRI Medications

Overview of SSRIs

SSRIs are Selective Serotonin Reuptake Inhibitors, which doesn't help much to clarify its meaning. In short, SSRIs are antidepressant drugs used in the treatment of depression, anxiety, as well as certain personality disorders. One cause of depression is related to low levels of serotonin, which are believed to induce the same feelings as a good mood. SSRIs prevent the reuptake of serotonin. In other words, these drugs slow the release of serotonin which helps it to be reused or recycled, and ultimately increases the level of serotonin in the body.

These are currently the most popular antidepressants. This is not necessarily due to their effectiveness (for some they work perfectly, for others it takes many tries and combinations), but their minimal side effects when compared to other antidepressant drugs. If SSRIs don't sound familiar to you, maybe Prozac, Paxil and Zoloft will ring a bell. These are all the prescription names of SSRI type drugs.

Although SSRIs have fewer side effects than other antidepressants, they still can cause a great deal of other symptoms. The possible side effects include decreased appetite, insomnia, increased anxiety, decreased sex drive, nausea or diarrhea, and headaches.

History of SSRIs

Research for alternative drugs to help depressed patients began as early as 1967. A psychiatry professor named Paul Kielholz led this research and started a new philosophy to encourage psychiatrists to not only diagnose and suggest treatments for depression, but for them to recognize that each patient will react differently to different antidepressants.

Another researcher, Arvid Carlsson, followed Kielholz's lead and continued the research by adding a different wrinkle to the methods. Carlsson suggested looking at the effects of not only increasing serotonin levels, but of increasing the levels by preventing the reuptake of serotonin (reuse/recycling of serotonin). The first drug produced was called Zelmid, which did not make it to US markets because of a serious side effect.

However, all this resulted in the release of Prozac in the US in 1987, when it became a top antidepressant drug. Many other types of SSRIs have followed Prozac, some with success and some still waiting to prove their effectiveness.

Types of SSRI Medications

• 1.Citalopram: Developed in 1989, it has continued to stay on the market with some generic branding. Like all SSRI antidepressants, it has side effects but is considered to have fewer drug interactions than other types.
• 2.Dapoxetine: As other SSRI antidepressants have been found to help with premature ejaculation in men, this is the first that is being considered solely for that reason. It is currently in approval stages with the FDA.
• 3.Escitalopram: Very similar to citalopram, it joined the ranks of the SSRIs with development in 1997 and approval in 2001 by the FDA. Since it is still a young version, the effectiveness is not quite clear, but has shown to be stronger than many other types and even effective in cases of severe depression.
• 4.Fluoxetine: The beginner and perhaps most widely known (Prozac) of all SSRIs, this research and development began in 1970. While it still continues to be widely used, this type of SSRI carries a warning by the FDA on its box that it may increase the risk of suicide in persons younger than 25.
• 5.Fluvoxamine: This SSRI is most widely used to treat obsessive-compulsive disorder (OCD). It fell out of popularity in the U.S. when it was announced that one of the shooters from Columbine was on this drug. However, it has been re-introduced to the U.S. and has been successful for many. It is now marketed as Luvox.
• 6.Paroxetine: This class of SSRI drug is used to treat many depression-related disorders. However, it has a good number of side effects and is considered controversial due to the suicidal link in the patients taking this drug.
• 7.Sertaline: Research for this SSRI began in 1970, but was not approved for use by the FDA until 1991. So far evidence suggests that it is more effective than Prozac for certain disorders. Also, proponents say it has the positive effects of tryclic antidepressants without the nasty side effects.
• 8.Zimelidine: The very first of the SSRIs to be marketed, it has since then been banned worldwide due to serious and fatal conditions connected to it, such as Guillan-Barre syndrome. Zelmid (the brand name) was the first SSRI antidepressant, even before Prozac.

List of SSRIs

The types of drugs in the class of SSRIs are as follows (with their brand name next to them):

• Citalopram: Brand names are Celexa, Cipramil, Dalsan, Emocal, Recital, Sepram, Seropram.
• Dapoxetine: This does not yet have a brand name as it is waiting approval from the FDA.
• Escitalopram: Brand names include Cipralex, Esertia and Lexapro.
• Fluoxetine: Brand names include Depress (UZB), Fontex, Fluctin (EUR), Fluox (NZ), Prozac, Sarafem, Seromex, and Seronil.
• Fluvoxamine: Brand names are Dumyrox, Favoxil, Fevarin, Luvox and Movox.
• Paroxetine: Brand names are Aropax, Deroxat, Paroxat, Paxil, Rexetin, Sereupin, Seroxat, and Xetanor.
• Sertaline: Brand names include Lustral, Serlain and Zoloft.
• Zimelidine: Brand names are Normud and Zelmid.

Drug interactions with SSRIs

Since the interactions can vary between different drugs, let's break it down by drug type. Beginning with the combination of SSRIs with other antidepressants, the following can occur:

• Combining SSRIs with tricyclic and tetracyclic antidepressants can result in abnormal heart rhythms.
• Combining SSRIs with monoamine oxidase inhibitors (MAOI's) can result in a very serious disease called serotonin syndrome. Symptoms of this potentially fatal disease include abrupt changes in vital signs, seizures, coma, vomiting, sweating and delirium.
• Combining SSRIs with Wellbutrin (Buproprion) can lead to an increased risk of seizures.

Antihistamines:

• Seldane/Hismanal combined with SSRIs may lead to fatal heart rhythms.
• Periactin may reverse the effects of SSRIs.

Diabetes Medications:

• Taking Orinase with SSRIs can result in low blood sugar.
• Insulin combined with SSRIs can decrease blood sugar, therefore needing to adjust the levels of insulin.

Heart and Blood Pressure Drugs:

• High blood pressure medications can slow down the heart and lead to ECG abnormalities.
• Abnormal heart rhythm medications combined with SSRIs may raise the risk of abnormal heart rhythms.
• Lanoxin/Crystodigin in combination with SSRIs can lead to mental confusion.

Psychiatric Drugs:

All of the following psychiatric drugs can have either increased side effects or additional side effects by combining with SSRIs antidepressants.

• Xanax/Valium
• BuSpar
• Lithium
• Methadone
• Mood stabilizers
• Tranquilizers
• Taking SSRIs with L-tryptophan, it may lead to serotonin syndrome.

Natural Alternatives to SSRIs

If the side effects are concerning, here are some natural alternatives to SSRIs. In other words, here are some ways to boost serotonin levels without drugs.

1.Exercise is one of the best proven natural ways to reduce stress and thus improve your mood. It has been shown that combining weight bearing activities with cardio is most effective.

2.Get some sun or other form of light therapy. Researchers already know the significance of a Vitamin D deficiency and depression, so don't be ashamed when you feel down after a week straight of gloomy days.

3.Talk it out. Some research is speculating that good old fashioned therapy is the way to go. A form called cognitive behavioral therapy has been shown to be successful for many cases.

4.Acupuncture is creeping back on the radar as an alternative to taking antidepressants, but as always, it depends on the severity of your condition.

5.Watch what you eat. This has nothing to do with weight gain or loss, but with the nutrients you put into your body. Certain foods boost serotonin levels (such as foods with tryptophan), while others can lower them (like simple carbohydrates).

6.Take an herbal or other form of a supplement. Many herbal or over-the-counter supplements have shown success for alleviating light depression. Look into 5-HTP, Gingko, St. John's Wort, Folate, Fish Oil, and SAM-e. Some of these also help to take in combination with SSRIs, while others not be advisable if you're already taking an antidepressant. Let's take a closer look at some of these.

• L-Tryptophan: Tryptophan is a substance found in many foods, especially protein, that increases the levels of serotonins. It is also available as a dietary supplement.
• SAM-e: Another dietary supplement, this has shown to help fight depression.
• Melatonin: This is a natural hormone found in animals and humans. It is typically taken as a sleep aid, but is also reported to help with depression.
• 5-HTP: A natural substance, it assists in converting tryptophan into serotonin. For this reason, it has shown to be effective in certain cases of fighting depression.
• L-Theanine: A substance commonly found in tea which increases the level of GABA production thus increasing serotonin levels.
• GABA: Gamma-aminobutyric acid plays a main role in the nervous system, including regulations of neuronal activity.
• Magnesium: It is hypothesized that a magnesium deficiency can lead to depression, increasing this can relieve that symptom.
• Taurine: This is a type of amino acid that plays a big role in different processes within the body, especially with the brain. It is believed that used as a dietary supplement, it can help people with depressive disorders, mainly bi-polar disorder.

Summary of SSRIs

These antidepressants seem to be helpful for certain people, but are not an across-the-board easy fix. Before deciding to go on these antidepressant drugs, do your own research and consult a physician or psychiatrist that knows you well and that you trust. Also, natural alternatives to SSRIs exist, either in combination or on their own. While these antidepressants have certainly helped many people cope with depression and other disorders, they do not work 100% of the time and their powerful effects should not be taken lightly. Still, because they offer so much hope for such serious conditions, they continue to be widely used.