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SSRIs are short for selective serotonin reuptake inhibitors (SSRIs). It is a broad group of psychoanaleptic drugs for depression that inhibit the reabsorption of serotonin by human neurons, which increases its concentration in the space between them. This results in better neurotransmission, and thus – increased stimulation of those cells that were “blocked” by depression.
SSRIs – when to use drugs from this group?
The indications for prescribing SSRIs to the patient are: depression, Asperger’s syndrome, PTSD, generalized anxiety, obsessive-compulsive disorder, social phobia and premature ejaculation. They are used as part of therapy, that is, for a long time.
Are SSRIs Safe?
Opinions vary on SSRIs. In the 90s, they were prescribed to patients on a massive scale. Improvement was noted in a large number of patients, and the attitude to these drugs was almost enthusiastic. Today, some argue that SSRIs are not worth taking. They give the following reasons:
- effectiveness equal to the placebo effect (approx. 33%), i.e. essentially saying that these drugs do not work and that you might as well use a sugar cube instead of them if the patient believed that it would help him; the effectiveness of the SSRI is greater in severe depression;
- prescribing many drugs “on trial” – combinations would not always be safe, not necessarily controlled and thought out;
- some psychological disorders result from the way of life – drugs will not work on the source of the problem, but only diminish its effect;
- chemicalisation of society (excess of consumed drugs);
- depression doesn’t just depend on serotonin levels.
On the other hand, the amount of negative feedback shouldn’t scare you. As the doctor rightly notes on one of the health portals: a person who has been helped by the drug usually does not waste time writing reviews about him. These are sick people, disappointed with the lack of improvement, withdraw from social and professional life so much that they have time to vent their dissatisfaction. The effectiveness of SSRIs is high, but mostly in severe depression (and that’s when the drug should be prescribed). How we evaluate a drug’s effectiveness depends primarily on how the study is conducted. A good doctor also does not prescribe drugs blindly. It is possible that he will not match them on the first visit (this is because depression is different for every person, as we have different connections of neurons in the brain) – and this is what subsequent visits and patient interviews are for. Neither are drugs merely “effect extinction” – it would be truer to say that they neutralize the biological cause of depression. The treatment of a psychological cause should be dealt with by a psychotherapist during psychological therapy, which should take place in parallel with taking medications. Depression is not only dependent on serotonin, but its poor flow is one of the most important blockages to feeling happy. It is also not true that drugs change a patient’s personality.
SSRI – drug side effects
SSRIs, like all drugs, have a wide variety of side effects that may or may not occur. The following are listed:
- anhedonia, i.e. the inability to feel happiness (in the case of depression it is already felt, and the side effect is its intensification),
- apathy or over-agitation
- decreased appetite,
- excessive sweating,
- lowering libido,
- hormonal disorders,
- possible increased risk of anemia (episodes)
- slight nausea, stomachache or headache.
SSRI – contraindications
In order to avoid the above-mentioned side effects, it is worth bearing in mind what are the contraindications for taking SSRIs. First of all, they cannot be taken together with MAO inhibitors or clomipramine. Mixing with trypaphone, dextromethorphan or sumatriptan can also end badly, there is a risk of serotonin syndrome, which is too much serotonin in the brain. Combining with tramadol an SSRI may lead to seizures. Some SSRIs affect the metabolism of the liver, which should be considered when taking substances that are broken down by the liver (such as methyl alcohol).
In situations of too rapid, abrupt discontinuation of SSRIs, the so-called withdrawal symptoms if the drugs have been taken for a long time. They last up to a few weeks and then disappear, so it is recommended to gradually reduce the amount of the drug taken. However, this does not mean that SSRIs are addictive – if they were, it would be much more difficult to stop them.