Commonly referred to as antidepressants, selective serotonin reuptake inhibitors (SSRIs) are a classification of prescription medication designed to treat moderate to severe depression . They’ve grown in popularity thanks to their effectiveness, and their propensity to cause fewer side effects than other types of antidepressants, such as tricyclic antidepressants (TCAs) or atypical antidepressants .

SSRIs can dramatically improve quality of life for people living with depression, but they aren’t for everyone. Here’s what you should know about the most popular SSRIs, and how ModRN Health can help you afford your antidepressant medication.

1. How they affect the brain

SSRIs work by increasing the levels of serotonin in your brain. Serotonin is a chemical messenger (neurotransmitters) that transmits signals between nerve cells (neurons). Other chemical messengers include dopamine and norepinephrine. SSRIs block the reabsorption (reuptake) of serotonin into your neurons in order to make more serotonin available. The more serotonin you have, the more efficiently your brain can transmit messages between neurons. SSRIs are called selective because they mainly affect serotonin, not other neurotransmitters. 

This differentiates them from serotonin-norepinephrine reuptake inhibitors (SNRIs) which may also be prescribed to treat major depression and certain anxiety disorders. Examples of SNRIs include desvenlafaxine (Pristiq), duloxetine (Cymbalta), and Venlafaxine (Effexor). Unlike SSRIs, these medications also inhibit the reabsorption of the neurotransmitter norepinephrine. 

2. They’re not just for depression

SSRIs have also been approved to treat other mental health conditions besides depression, including anxiety. If you’re living with an anxiety disorder or symptoms of depression, an SSRI may be right for you. These 5 SSRIs have all been approved by the Food and Drug Administration (FDA) to treat major depressive disorder (depression) and other mental health conditions, and are popular choices for otherwise healthy individuals:

• Citalopram (Celexa)
• Escitalopram (Lexapro)
• Fluoxetine (Prozac)
• Paroxetine (Paxil, Pexeva)
• Sertraline (Zoloft)

3. They’re effective - but they’re not without side effects

Because all SSRIs essentially work in a similar way, they also have similar side effects. Some people are fortunate to not experience any side effects during treatment with these antidepressant drugs, while others experience them only for a short time. It’s most common to experience side effects during the first few weeks of treatment.

Each medication has different potency, so if one doesn’t work for you - or causes uncomfortable side effects - you may still be able to reap the benefits of an SSRI antidepressant medication. Simply talk to your doctor about what you’re experiencing. They’ll be able to recommend an antidepressant that’s a better fit, or find you a medication better suited to your needs.

Possible side effects of antidepressants may include:

• Nausea, vomiting or diarrhea
• Headache
• Drowsiness
• Dry mouth
• Insomnia
• Nervousness, agitation or restlessness
• Dizziness
• Blurred vision
• Sexual problems, such as reduced sex-drive, difficulty reaching orgasm or inability to maintain an erection (erectile dysfunction)
• Impact on appetite, leading to weight loss or weight gain

Simple adjustments like taking your medication with food may reduce antidepressant side effects such as nausea. You can also offset common side effects like drowsiness by taking your antidepressant medication at bedtime.

Rarely, an SSRI can cause serotonin syndrome, a dangerous condition which causes high levels of serotonin to accumulate in your body. This occurs most often when two medications that raise serotonin are combined, such as certain pain or headache medications, and herbal supplements. Symptoms include anxiety, agitation, high fever, sweating, confusion, tremors, restlessness, lack of coordination, major changes in blood pressure and a rapid heart rate.

4. But DON’T stop them suddenly

SSRI antidepressant medications aren't addictive but it is still dangerous to stop taking them abruptly. Doing so - or even missing several doses of your antidepressant treatment - can cause withdrawal-like symptoms. Doctors call this discontinuation syndrome. You can certainly stop taking your antidepressant, but be sure to work with your prescribing doctor to gradually and safely decrease your dose to minimize withdrawal symptoms.

Withdrawal-like symptoms can include:

• General feeling of uneasiness
• Nausea
• Dizziness
• Lethargy
• Flu-like symptoms

5. There can be serious risks

For most people, SSRIs are safe, and in fact, can improve their health and quality of life. However, that doesn’t mean they are without risk. For example, high doses of citalopram may cause dangerous abnormal heart rhythms (arrhythmia). For that reason, the FDA recommends that you avoid doses over 40 milligrams (mg) a day. The recommended dose is 20 mg a day for people over age 60.

Before you take an SSRI talk with your doctor about any and all medications and supplements you’re currently taking. Some supplements can interact with your antidepressant medication and cause a dangerous interaction, or lessen their effectiveness. SSRIs may also increase your risk of bleeding, especially when combined with medications that increase the risk of bleeding.

Antidepressants may not be safe during pregnancy. Talk to your doctor about the risks and benefits of using specific antidepressants while pregnant or breastfeeding. Don't stop taking your medication without contacting your doctor first, as stopping might pose risks for you.

6. They can actually increase suicidal thoughts

In the long run, antidepressant medications can lower suicide risk. However, as counter-intuitive as it seems, in some cases, children, adolescents and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressant medication, especially in the first few weeks after starting or when the dose is changed. Most SSRI antidepressants are generally safe, but the FDA requires that all antidepressant drugs carry black box warnings, the strictest warnings for prescriptions, and it’s important warning you should consider before starting one, or before considering one for your child or teenager.

If you or someone you love begins treatment for depression with an antidepressant medication, it’s important to monitor the effects closely. Pay close attention for worsening depression or unusual behavior. If suicidal thoughts are present, immediately contact your doctor or get emergency help.

7. They don’t work the same way for everyone

Not everyone will react the same to the same antidepressant treatment. The medication that works beautifully for you may be ineffective for someone else, or you may experience nausea or sweating that someone else escapes. Your brain chemistry and DNA are unique to you, so it’s impossible to predict exactly how you’ll react to an SSRI. Inherited traits play a role in how antidepressants affect you. If you have a close relative who responded to a particular antidepressant, let your doctor know, as you may be predisposed to have similar effects.

In some cases, results of special blood tests, where available, may offer clues about how your body may respond to a particular antidepressant. However, other variables can affect your response to medication and your prescribing physician may recommend an alternative antidepressant treatment, such as monoamine oxidase inhibitors (MAOIs) or a serotonin-norepinephrine reuptake inhibitor (SNRI).

8. They’ll take time to work 

If you’re starting an antidepressant medication, chances are you’re feeling pretty poorly. As much as you may long for relief, it may take several weeks - possibly longer - before an antidepressant drug reached peak effectiveness. It may also take that long for the initial side effects to ease up. If you’re experiencing difficulties, or if you’re not seeing any improvements, talk with your doctor about adjusting your dose, or potentially switching your medication. Above all, be patient, and communicate clearly with your doctor, therapist, and other healthcare provider about your needs and concerns.

When choosing the right antidepressant medication to treat your moderate to severe depression, your doctor will consider multiple factors, including your symptoms, any health problems, other medications or supplements and what has worked for you in the past.

The cost of treatment can prevent some people from getting the help they need. If you’re living with depression, antidepressants can help you regain your quality of life. Find out how to make prescription depression treatment medications more affordable with help from ModRN Health . ModRN Health can help you save up to 80% on your medications. Simply search for your meds, and find the best prices locally, right now. 

Read More 

5 Ways You Can Support a Loved One Living with Depression

Zulresso and Other Treatments for Post-Partum Depression

Suffering from Depression? 'Discuss Therapy and Medication Options with your Doctor'

Depression 'higher among patients with atopic dermatitis'