Pros and cons of SSRI medications

 

The fact is that there are many different types of medications which are available to treat this very common but rather serious condition but the fact is also that in the past few years- things about treatment have changed a bit. How come? Well, these newer medications for depression have become available that are safer and more effective than older medications for depression causing significantly fewer side effects. Although patients sometimes call them the “perfect” –it is crucial to remember that all medications carry certain risks. There are several different classes of medications for depression but the three most commonly used are:

Common SSRI medications include Paxil, Luvox, Zoloft, Serozone and Prozac. The fact is that Effexor was at one time considered an SSRI, but has now been reclassified as a SNRI.

It is important to point out that depression is one very serious disorder characterized by significant problems in mood, thinking, and behavior. Although some believe that it is not so common condition- most of the studies tell differently! It is estimated that major depressive disorder affects about 5 percent of adolescents. It is also proven that selective serotonin reuptake inhibitors could be extremely beneficial to children and adolescents with this depressive disorder. There is one huge problem- the fact is that recently; there has been some concern that the use of these medications may induce suicidal behavior in youths. That’s why US FDA has published a warning about an increased risk of suicidal thoughts or behavior in children and adolescents treated with SSRI antidepressant medications. Pretty serious!

Several researches done in the past have came to the conclusion that the depression is about missing certain neurotransmitters in the central nervous system. One of the most important is serotonin, also known as 5-hydroxytryptamine or 5-HT. Main thing about these SSRIs is that they are able to slow down the process of returning the serotonin to the end of the neuron it comes from. Why is this so important? Well – this will lead to the longer presence of this neurotransmitter on the receptor, making it more likely that enough will build up to set off the impulse in the next neuron. Therefore- these medications work by allowing the body to make the best use of the reduced amounts of serotonin that it has at the time.  

 

Like it was been already told- everyone should know that the main and primary indication for SSRIs is clinical depression. Beside this main indication- SSRIs are also prescribed for anxiety disorders such as:

·                social anxiety

·                panic disorders

·                obsessive-compulsive disorder (OCD)

·                eating disorders

·                irritable bowel syndrome (IBS)

·                premature ejaculation

 

It is extremely important to remember that SSRIs are contraindicated with simultaneous use of MAOIs (monoamine oxidase inhibitors) - also a type of antidepressants! Several researches done in the past have confirmed that this can lead to increased serotonin levels which could cause a serotonin syndrome. They are also contraindicated for

People that are taking pimozide (a diphenylbutylpiperidine derivative), analgesic tramadol hydrochloride…

Well, like with any other drug- these antidepressants can cause several possible side effects and the most common are gastro-intestinal such as:

·          feeling sick

·          vomiting

·          indigestion

·          abdominal pain

·          diarrhea

·          constipation

Other side effects include:

·          irritability

·          anxiety

·          sleeplessness

·          drowsiness

·          headache

·          shaking

·          dizziness

·          convulsions

·          disturbance of sexual function

·          sweating

·          low sodium level

·          suicidal ideas

·          loss of appetite, weight loss

·          increased appetite, weight gain

·          allergic reactions

·          dry mouth

·          bruising

·          manic or hypomanic behaviour

·          abnormal movements

Drug® generic name	Dose/day	Possible Side Effects
Effexor®/venlafaxine	75-375 mg	high blood pressure sexual dysfunction
Paxil®/paroxetine	20-50 mg	fatigue sexual dysfunction
Prozac®/fluoxetine	20-80 mg	anxiety insomnia sexual dysfunction
Serzone®/nefazodone	300-600 mg	drowsiness
Welbutrin®/buproprion	300-450 mg	weight loss slight (.4%) risk of seizures
Zoloft®/sertraline	50-200 mg	drowsiness insomnia sexual dysfunction

It is extremely important to point out that these last couple of year- there have been many cases of patient suicidal ideation and behavior. Unfortunately-there is almost no scientific support for this claim. Families of the patient s normally have blamed medications but manufactures have denied any such link and have always blamed the disease rather than the treatment. In 2003 the UKs Committee on Safety of Medicines and in early 2006 GlaxoSmithKline have issued a press release about some clinical data which showed a statistically significant higher frequency of suicidality in patients treated with their SSRI, paroxetine (Paxil) than with placebo. That’s why- since then; in the United States there is a required box warning for suicide risk in children but not for adults.

 

Although patients don’t know a lot about this possible side effect- the fact is that it is proven that the selective serotonin reuptake inhibitors (SSRIs) can cause various types of sexual dysfunction such as:

Good thing is that these dysfunctions occasionally disappears spontaneously without stopping the SSRI, and in most cases resolves after discontinuance and it is believed that it is caused by an SSRI induced reduction in dopamine. Some other researches have shown that the antidepressants used single can't cause this but rather when used when some of the medications such as: bupropion, buspirone, methylphenidate, mirtazapine, amphetamine, pramipexole and ropinirole.  

 

Although not too many patients know this- it is important to point out that these antidepressants are not addictive in the conventional medical use of the word. Therefore, person can stop using them whenever it wants but- suddenly discontinuing their use is known to produce both somatic and psychological withdrawal symptoms. Patients claim they feel extremely uncomfortable if they miss a few doses or discontinue these drugs suddenly. They report:

Experts are saying that they really can explain how common withdrawal symptoms are or how long they are likely to last.  

 

Patients have also complained about loss of effect and it really represents a problem with longer term use of the SSRIs. Experts are saying that the phenomenon could be due to down regulation of the neuroreceptors, and may occur more often with the SSRIs than with other antidepressants.

 

What’s good about this type of antidepressants? It is proven that SSRIs appear to be safer in overdose when compared with traditional antidepressants such as the tricyclic antidepressants. How come? Well, this is supported both by case series and studies of deaths per numbers of prescriptions.  That’s why they represent the most commonly used antidepressants! Because of the wide therapeutic index of the SSRIs, most patients will have mild or no symptoms following moderate overdoses. The most commonly reported severe effect following SSRI overdose is:

 

Patients have also reported some strange but favorable side effects! One of the SSRI's "best" side effects is appetite reduction and weight loss. In fact, that was a big reason that Prozac found fame so fast.

 

All patients should know that one of the most commonly used and sometimes even call the ‘wonder drug’ antidepressant that has appeared in recent years is Prozac. How come? Well, the fact is that Prozac is a powerful drug that operates at a deep level of the brain to correct a biochemical imbalance that not only seems to underlie depression, but a variety of other body/mind problems as well.

Major problem is that patients are sometimes “blind” and ignore the fact that the new SSRI's have produced amazing results for many users, but also that shouldn't obscure the fact that others have had problems with them.

Of course, it is reasonable to assume that due to the expensive cost and side effects of medications for depression, people in the United States have increasingly turned to natural medications for depression. Patients should be aware that they will not get some “wonder” plant as a cure and although many natural supplements are low quality and don’t work as well as prescription medications for depression, a few high-quality natural depression supplements do exist.