List of ssris
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Comprehensive List of Selective Serotonin Reuptake Inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs widely used in the treatment of various mood and anxiety disorders. They are known for their efficacy, tolerability, and safety profile compared to older antidepressants. This article provides a detailed list of SSRIs, their common uses, and some considerations regarding their effects and side effects.
Common SSRIs and Their Uses
Fluoxetine
Fluoxetine is one of the most well-known SSRIs and is commonly used to treat major depression, obsessive-compulsive disorder (OCD), bulimia nervosa, and panic disorder. It has also demonstrated safety in pregnancy .
Sertraline
Sertraline is another widely prescribed SSRI, effective in treating major depressive disorder, OCD, panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder .
Paroxetine
Paroxetine is used for major depressive disorder, OCD, panic disorder, social anxiety disorder, generalized anxiety disorder, and PTSD. It is known for its efficacy but also has a higher incidence of withdrawal symptoms upon discontinuation .
Fluvoxamine
Fluvoxamine is primarily used for the treatment of OCD and social anxiety disorder. It is less commonly prescribed for depression compared to other SSRIs .
Citalopram
Citalopram is used to treat major depressive disorder and is known for its favorable side-effect profile. It is also used off-label for various anxiety disorders .
Escitalopram
Escitalopram, the S-enantiomer of citalopram, is used for major depressive disorder and generalized anxiety disorder. It is often preferred due to its improved tolerability and efficacy .
Vilazodone
Vilazodone is a newer SSRI that also acts as a partial agonist at the serotonin 1A receptor. It is used for major depressive disorder and has been available since 2011.
Efficacy and Safety Profile
SSRIs are generally preferred over older antidepressants like tricyclic antidepressants and monoamine oxidase inhibitors due to their better safety profile, especially in overdose situations, and fewer side effects . They are effective in treating a wide range of disorders, including major depression, dysthymia, panic disorder, OCD, eating disorders, and premenstrual dysphoric disorder .
Side Effects and Withdrawal Symptoms
Common side effects of SSRIs include gastrointestinal disturbances, headache, sedation, insomnia, weight gain, impaired memory, excessive perspiration, paresthesia, and sexual dysfunction . Withdrawal symptoms can occur upon discontinuation, and these can include dizziness, nausea, lethargy, and flu-like symptoms. Paroxetine, in particular, is associated with a higher incidence of withdrawal symptoms.
Special Considerations
Use in Children and Adolescents
The use of SSRIs in children and adolescents is controversial due to concerns about increased risk of suicidal ideation and behavior. Fluoxetine is the only SSRI with consistent evidence of efficacy in this population, but caution is advised.
Impact on Insulin Secretion
Recent studies have shown that SSRIs can inhibit insulin secretion and action in pancreatic β cells, potentially accelerating the transition from an insulin-resistant state to overt diabetes.
Migraine and Tension-Type Headache Prevention
SSRIs have been evaluated for the prevention of migraine and tension-type headaches, but evidence does not support their use for these indications. They are no more effective than placebo or other treatments like amitriptyline .
Conclusion
SSRIs, including fluoxetine, sertraline, paroxetine, fluvoxamine, citalopram, escitalopram, and vilazodone, are essential tools in the treatment of various mood and anxiety disorders. While they are generally well-tolerated and effective, clinicians must be mindful of their side effects, withdrawal symptoms, and specific considerations in different populations.
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