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Selective serotonin reuptake inhibitor: Difference between revisions
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'''Selective serotonin reuptake inhibitors''' (commonly abbreviated as '''SSRIs''') are a class of pharmaceutical [[antidepressant]] medications. They are commonly prescribed for the treatment of major depressive disorders. Other conditions include anxiety disorders, obsessive-compulsive disorder, migraine, attention-deficit hyperactivity disorder (ADHD), addiction/dependence, and sleep disorders. The exact pharmacological mechanism of action SSRIs is unknown.<ref>http://pi.lilly.com/us/prozac.pdf page 20</ref> They are believed to increase the extracellular level of the [[neurotransmitter]] [[serotonin]], eventually leading to improved mood.{{citation needed}}{{clarify}} | '''Selective serotonin reuptake inhibitors''' (commonly abbreviated as '''SSRIs''') are a class of pharmaceutical [[antidepressant]] medications. They are commonly prescribed for the treatment of major depressive disorders. Other conditions include anxiety disorders, obsessive-compulsive disorder, migraine, attention-deficit hyperactivity disorder (ADHD), addiction/dependence, and sleep disorders. The exact pharmacological mechanism of action SSRIs is unknown.<ref>http://pi.lilly.com/us/prozac.pdf page 20</ref> They are believed to increase the extracellular level of the [[neurotransmitter]] [[serotonin]], eventually leading to improved mood.{{citation needed}}{{clarify}} | ||
SSRIs can be dangerous when used in combination with other substances that increase or modulate serotonin such as [[MDMA]] and [[MAOI|Monoamine Oxidase Inhibitors]] (MAOIs). A combination with these substances can lead to [[serotonin syndrome]] and potentially be fatal. SSRIs do not work for everyone and take 3-6 weeks to start having noticeable effects.<ref>https://psychcentral.com/ | SSRIs can be dangerous when used in combination with other substances that increase or modulate serotonin such as [[MDMA]] and [[MAOI|Monoamine Oxidase Inhibitors]] (MAOIs). A combination with these substances can lead to [[serotonin syndrome]] and potentially be fatal. SSRIs do not work for everyone and take 3-6 weeks to start having noticeable effects.<ref>{{Citation | year=2021 | title=Do Antidepressants Work Right Away? | url=https://psychcentral.com/depression/how-long-do-antidepressants-take-to-work}}</ref> | ||
SSRIs are reported to have fewer side effects than older antidepressants like [[MAOI|monoamine oxidase inhibitors]] and [[tricyclic antidepressants]].{{citation needed}} [[MAOI|Monoamine oxidase inhibitors]] also interact with many other medications and foods, leading to a hypertensive crisis that can potentially be fatal. SSRIs can cause sexual dysfunction and compulsive yawning as side effects. Discontinuation of SSRIs can lead to withdrawal symptoms which include flu-like symptoms, as well as [[brain zaps]]. | SSRIs are reported to have fewer side effects than older antidepressants like [[MAOI|monoamine oxidase inhibitors]] and [[tricyclic antidepressants]].{{citation needed}} [[MAOI|Monoamine oxidase inhibitors]] also interact with many other medications and foods, leading to a hypertensive crisis that can potentially be fatal. SSRIs can cause sexual dysfunction and compulsive yawning as side effects. Discontinuation of SSRIs can lead to withdrawal symptoms which include flu-like symptoms, as well as [[brain zaps]]. | ||
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SSRIs are believed to increase the extracellular level of the [[neurotransmitter]] [[serotonin]] by [[Reuptake inhibitor|limiting]] its reuptake into the presynaptic cell, increasing the level of [[serotonin]] in the synaptic cleft available to bind to the postsynaptic receptor. They have varying degrees of selectivity for the other monoamine transporters. Pure SSRIs show only weak affinities for the [[noradrenaline]] and [[dopamine|dopamine transporter]]s. | SSRIs are believed to increase the extracellular level of the [[neurotransmitter]] [[serotonin]] by [[Reuptake inhibitor|limiting]] its reuptake into the presynaptic cell, increasing the level of [[serotonin]] in the synaptic cleft available to bind to the postsynaptic receptor. They have varying degrees of selectivity for the other monoamine transporters. Pure SSRIs show only weak affinities for the [[noradrenaline]] and [[dopamine|dopamine transporter]]s. | ||
SSRIs also lead to an increased level of cAMP (cyclic adenosine monophosphate), brain-derived neurotrophic factor, and several other regulatory neuromodulators. Different SSRIs have different binding profiles, which may lead to different effects.<ref>Kolb, | SSRIs also lead to an increased level of cAMP (cyclic adenosine monophosphate), brain-derived neurotrophic factor, and several other regulatory neuromodulators. Different SSRIs have different binding profiles, which may lead to different effects.<ref>{{cite book | vauthors=((Kolb, B.)), ((Whishaw, I. Q.)) | date= 2005 | title=An introduction to brain and behavior | publisher=Worth Publishers | edition=2nd ed | isbn=9780716711872}}</ref> | ||
==Subjective effects== | ==Subjective effects== | ||
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*'''[[Effect::Irritability]]''' | *'''[[Effect::Irritability]]''' | ||
*'''[[Effect::Motivation suppression]]''' | *'''[[Effect::Motivation suppression]]''' | ||
*'''[[Effect::Suicidal ideation]]''' <ref>Björkenstam, C., Möller, J., | *'''[[Effect::Suicidal ideation]]''' <ref>{{cite journal | vauthors=((Björkenstam, C.)), ((Möller, J.)), ((Ringbäck, G.)), ((Salmi, P.)), ((Hallqvist, J.)), ((Ljung, R.)) | journal=PLoS ONE | title=An Association between Initiation of Selective Serotonin Reuptake Inhibitors and Suicide - A Nationwide Register-Based Case-Crossover Study | volume=8 | issue=9 | pages=e73973 | date=9 September 2013 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767591/ | issn=1932-6203 | doi=10.1371/journal.pone.0073973}}</ref> - Upon first introduction, some users (especially people under the age of 25)<ref>{{Citation | title=What to know about antidepressants for kids and teens | url=https://www.mayoclinic.org/diseases-conditions/teen-depression/in-depth/antidepressants/art-20047502}}</ref> can experience increase suicidal and self harming thoughts and behaviors. This effect usually subsides within 6-8 weeks. | ||
*'''[[Effect::Insomnia]]''' | *'''[[Effect::Insomnia]]''' | ||
}} | }} | ||
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==Examples== | ==Examples== | ||
===Citalopram=== | ===Citalopram=== | ||
Citalopram is an SSRI sold under the brand name '''Celexa''' in the United States. Citalopram is indicated for the treatment of a major depressive disorder. Citalopram was approved in 1998 by the Food and Drug Administration for the treatment of major depressive disorder.<ref> | Citalopram is an SSRI sold under the brand name '''Celexa''' in the United States. Citalopram is indicated for the treatment of a major depressive disorder. Citalopram was approved in 1998 by the Food and Drug Administration for the treatment of major depressive disorder.<ref>{{cite book | vauthors=((PhD, C. B. N. M.)) | date=5 June 2012 | title=Management of Treatment-Resistant Major Psychiatric Disorders | publisher=Oxford University Press | isbn=9780199974146}}</ref> Citalopram is almost exclusively found as the hydrobromide salt, which is the only form approved by the FDA.<ref>Citalopram | https://www.drugs.com/citalopram.html</ref> | ||
===Escitalopram=== | ===Escitalopram=== | ||
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===Fluvoxamine=== | ===Fluvoxamine=== | ||
Fluvoxamine is an SSRI that is used to treat obsessive-compulsive disorder. Fluvoxamine was first approved by the FDA in 1994.<ref>Fluvoxamine | https://www.drugs.com/cdi/fluvoxamine.html</ref>Fluvoxamine has the greatest affinity for the σ1 (sigma-1) receptor, where it acts as an [[agonist]], which may contribute to its biological effects.<ref>Sigma-1 receptors and selective serotonin reuptake inhibitors: clinical implications of their relationship | Fluvoxamine is an SSRI that is used to treat obsessive-compulsive disorder. Fluvoxamine was first approved by the FDA in 1994.<ref>Fluvoxamine | https://www.drugs.com/cdi/fluvoxamine.html</ref>Fluvoxamine has the greatest affinity for the σ1 (sigma-1) receptor, where it acts as an [[agonist]], which may contribute to its biological effects.<ref>{{cite journal | vauthors=((Hashimoto, K.)) | journal=Central Nervous System Agents in Medicinal Chemistry | title=Sigma-1 receptors and selective serotonin reuptake inhibitors: clinical implications of their relationship | volume=9 | issue=3 | pages=197–204 | date= September 2009 | issn=1875-6166 | doi=10.2174/1871524910909030197}}</ref> | ||
===Paroxetine=== | ===Paroxetine=== | ||
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===Sertraline=== | ===Sertraline=== | ||
Sertraline is an SSRI that is sold under the brand name '''Zoloft'''. Sertraline is used to treat major depressive disorder, obsessive-compulsive disorder, post-traumatic stress disorder, anxiety disorders, panic disorder, and premenstrual dysphoric disorder. Sertraline was first FDA approved in 1991.<ref>Sertraline | https://www.drugs.com/sertraline.html</ref>Unlike most SSRIs, sertraline, has somewhat significant activity at the [[dopamine]] transporter protein<ref>Second generation | Sertraline is an SSRI that is sold under the brand name '''Zoloft'''. Sertraline is used to treat major depressive disorder, obsessive-compulsive disorder, post-traumatic stress disorder, anxiety disorders, panic disorder, and premenstrual dysphoric disorder. Sertraline was first FDA approved in 1991.<ref>Sertraline | https://www.drugs.com/sertraline.html</ref>Unlike most SSRIs, sertraline, has somewhat significant activity at the [[dopamine]] transporter protein<ref>{{cite journal | vauthors=((Owens, J. M.)), ((Knight, D. L.)), ((Nemeroff, C. B.)) | journal=L’Encephale | title=[Second generation SSRIS: human monoamine transporter binding profile of escitalopram and R-fluoxetine] | volume=28 | issue=4 | pages=350–355 | date= August 2002 | issn=0013-7006}}</ref> and could be considered a serotonin-dopamine reuptake inhibitor. | ||
===Other SSRIs=== | ===Other SSRIs=== | ||