Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are compounds commonly used to treat depression, anxiety, and personality disorders. In some cases, SSRIs can also be used to treat insomnia or premature ejaculation problems. Selective serotonin reuptake inhibitors (SSRIs) stem from a larger class of serotonergic antidepressants, which are antidepressants that work with the neurotransmitter serotonin. Included in the class of serotonergic antidepressants are also serotonin-norepinephrine-dopamine reuptake inhibitors and selective serotonin reuptake enhancers, among others. SSRIs form a subclass of these serotonergic antidepressants which also includes non-selective serotonin reuptake inhibitors. SSRIs are more widely used than the non-selective serotonin reuptake inhibitors, because SSRIs only affect the serotonin related reuptake receivers, whereas non-selective inhibitors also affect other types of monoamine neurotransmitters. Using a selective process eliminates some side effects of taking the drug. SSRIs were the first class of drugs that both dealt directly with the central nervous system and were designed with a specific drug target in mind. Serotonin is a chemical neurotransmitter that manages functions such as mood, sleep, and appetite, which is why SSRIs are extremely useful as antidepressants.

Selective serotonin reuptake inhibitors (SSRIs) are thought to work by inhibiting the serotonin receivers on the presynaptic cell. In between nerve cells, there is a space called the synapse, where messages, called neurotransmitters, are transferred from one cell to another. The presynaptic cell, or the cell that is sending the message, releases neurotransmitters across the synapse that are then recognized and bound by the postsynaptic cell (the cell that is receiving the message). The neurotransmitters then return to the presynaptic cell where they are received by the monoamine transporters (the same ones that sent the neurotransmitters out originally) in a process called reuptake. SSRIs work by preventing the reuptake of serotonin by these monoamine transporters. Because the serotonin is not involved in reuptake, it stays in the synapse longer and stimulates the postsynaptic receivers again and again. This is thought to increase the number of nerve impulses and improves a patient’s mood.

Though the method that SSRIs use to have their effects is not completely understood, they are nevertheless an effective treatment for depression, among other disorders. However, they can be dangerous if not used properly or in conjunction with other medications. Patients considering the use of SSRIs should consult fully with their doctor before beginning treatment. For example, SSRIs may have harmful interactions with monoamine oxidase inhibitors (another type of antidepressant), herbal medications, alcohol, benzodiazepines like Valium or Xanax, drugs that affect the central nervous system, and others. The extent of the effects of SSRIs is also due to a patient’s genetic makeup, especially how a patient’s serotonin receptors work and what the patient’s alleles, the chromosomes involved with inherited traits, are like.

Selective serotonin reuptake inhibitors (SSRIs) are the most widely used antidepressants, and common drugs that are classified as SSRIs include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro). However, side effects do exist and include nausea, headache, drowsiness, insomnia, weight gain, and sexual problems. 

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