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Brands / Types

The most common SSRIs are: Citalopram (Celexa), Fluoxetine (Prozac), Fluvoxamine (Luvox), Paroxetine (Paxil), Sertraline (Zoloft), and Trazodone (Desyrel).

Although it does weakly inhibit serotonin reuptake, bupropion (Wellbutrin) is generally not classified as an SSRI because it also inhibits the reuptake of both norepinephrine and dopamine.

Dose

SSRI dosages vary from chemical to chemical.

Law

SSRIs as a grouping are not specifically mentioned in any schedule or law. A number of chemicals within the SSRI grouping are available by prescription only.

Pharmacology / Mechanism of Action

There are specific serotonin axons in the brain which, amongst other things, release serotonin into the space between the axons and neurons (the 'inter-synaptic gap'). The released serotonin hangs out in this inter-synaptic gap, and from there can move in a variety of directions. Some of the serotonin fits into specific receptors on neurons triggering an electro-chemical message of sorts to be sent through the brain. But there are far more serotonin molecules released than will actually find a neuronal receptor to trigger, so some serotonin molecules will be grabbed by 'serotonin reuptake transporters' on the serotonin axons like the ones from which they were originally released. Still other serotonin molecules are destroyed by MAO enzymes in the inter-synaptic gap (this is the process which is inhibited by MAOIs). This is a complex inter-related process which regulates the amount of serotonin that is floating about in the inter-synaptic gap, and thereby also regulates the number of serotonin receptors that are being triggered.

SSRIs block the serotonin reuptake transporters so they are temporarily no longer capable of moving serotonin out of the inter-synaptic gap and back into the axon. Functionally what this does is to increase the amount of serotonin in the inter-synaptic gap, and therefore also increase the number of serotonin receptors which are being triggered.

Adverse Reactions
Adverse reactions to SSRIs can include anxiety, headache, tremors, dizziness, sleep disturbances, and sexual dysfunction. Less common negative reactions include nose bleeds, fever, skin rash, weight gain/loss, seizures, hyponatremia, and suicidal ideation. Individual chemicals with SSRI activity may cause additional types of adverse reactions.

Contraindications

• SSRIs should not be used in combination with MAOIs. This combination can lead to serotonin syndrome, which can be dangerous and/or deadly.
  
  
• SSRIs should be avoided by those with a history of seizure disorder as well as in debilitated patients or those taking multiple medications, because of the possibility of drug-induced seizure.
  
  
• SSRIs should only be used with caution in those with a history of liver problems.
  
  
• Use of SSRIs in breast-feeding women is not generally recommended as SSRIs appear in breast milk.