Fluoxetine (Prozac), escitalopram and sertraline are three of the most common SSRI antidepressants.
SSRI antidepressants are also known as “the drug of happiness”. This type of medication is used mainly for the treatment of major depression and dysthymia and is considered the treatment of the first choice for this type of mental pathologies.
Next, we will review what SSRIs are, what their mechanism of action is, and for what type of psychological disorders they are usually indicated, what are the 6 main types and what side effects they can cause.
SSRI (selective serotonin reuptake inhibitors)
Selective serotonin reuptake inhibitors (5-HT) or SSRIs are a group of antidepressants that include medications such as fluoxetine (Prozac) or sertraline (Zoloft), among others.
In relation to its mechanism of action, they are considered serotonergic functional agonists; this means that they perform an active blockade in the serotonin reuptake pumps in the brain.
They present a good absorption by ingestion by the oral route (only used), are metabolized in the liver and their excretion is of the renal type. They also have a very high therapeutic index since they have low toxicity, do not enhance the effects of alcohol and are not considered addictive.
SSRIs are indicated for major depressive disorder and for other types of mental disorders. These include panic disorder with or without agoraphobia, generalized anxiety (deep down, are better anxiolytics than antidepressants), post-traumatic stress disorder, social phobia, bulimia (specifically fluoxetine), obsessive-compulsive disorder -compulsive, aggression and impulsive behavior, premenstrual dysphoric disorder, fibromyalgia and premature ejaculation (since they produce delay in orgasm).
Still, SSRIs are contraindicated for people with thoughts of suicide, hypomania (they increase the manic picture), bipolar disorder, diabetes, epilepsy, inhibited sexual desire and kidney disorders such as hyponatremia and hypovolemia.
Why are the antidepressants of the first choice?
The fact that they are considered the first-choice treatment for most depressive disorders is due to the fact that in the early 2000s, SSRIs replaced tricyclic antidepressants until now considered the main psychopharmacological treatment for depressive disorders.
This was so because the tolerability and safety they presented were much greater than that of the tricyclics. They also tended to produce fewer adverse effects than these and were less dangerous in the event of an overdose.
The prescription of SSRIs in children and adolescents from 10 to 19 years has increased considerably in recent years. Some studies have coincided in finding a significant decrease in suicide rates in this age group, but it is still unknown if these drugs are directly responsible for the improvement.
The 6 types of SSRI antidepressants
Although the mechanism of essential action is the same (inhibition of serotonin) and are equally safe (even in cases of overdose), each of the drugs in this group has its own profile with a different clinical activity and side effects, as well They are usually indicated to treat different disorders.
Next, we will cite the 6 types of SSRI antidepressants, the name of their main trademarks, their respective indications, and the recommended doses.
The commercial names of this drug are Calton, Citalopram EFG, Citalvir, Prisdal, Seropram, and Relpax. It is usually prescribed in doses of 20 to 60 mg per day and is indicated to treat major depression and dysthymia.
Escitalopram is sold under the brands Cipralex, Esertia and Escitalopram EFG. The recommended dose of escitalopram is 10 to 40 mg per day and is usually prescribed for the treatment of major depression and dysthymia.
Fluoxetine is best known for its Prozac trademark; even so, it also has other commercial names such as Aden, Lecimar, Luramon, Fluoxetine EFG, and Reneuron. Aden, Prozac, and Reneuron are also available in weekly presentations.
The recommended dose is usually 20 to 80 mg and is indicated for major depression, dysthymia, panic disorder, obsessive-compulsive disorder, bulimia, and premenstrual dysphoric disorder.
Dumirox and Fluvoxamine EFG are the names of the trademarks of fluvoxamine. This antidepressant psycho-drug is taken in doses of 50 to 300 mg per day and is only indicated for obsessive-compulsive disorder (OCD).
Paroxetine is prescribed in doses of 20 to 50 mg per day and is also known for Daparox, Frosinone, Motivation, Paroxetine, EFG, and Seroxat. Premenstrual dysphoric disorder, post-traumatic stress disorder, social phobia, obsessive-compulsive disorder, generalized anxiety disorder, anxiety disorder, dysthymia, and major depression are the main indications of this medication.
This psychopharmaceutical is sold under the commercial names of Altisben, Aramis, Besitran and Sertraline EFG.
It is mainly used in the treatment of panic disorder but it is also indicated for major depression, dysthymia, obsessive-compulsive disorder, social phobia, post-traumatic stress disorder, and premenstrual dysphoric disorder. It is usually prescribed in doses of 50 to 200 mg daily.
Common side effects
The main adverse effects of SSRIs include nervousness, diarrhea, drowsiness, hyperhidrosis, headache, nausea, sexual dysfunction, and insomnia.
Among the less frequent are abdominal pain, loss, and increased hunger, constipation, blurred vision, arthralgia and myalgia, tremors and tachyarrhythmias. These effects may be transient and vary depending on the type of antidepressant.
In case of loss of libido or sexual desire, bupropion can be prescribed either to decrease the dose or to substitute the drug for another non-SSRI antidepressant.