Selective Serotonin Reuptake Inhibitors For Treatment Of Depression

Selective serotonin reuptake inhibitors, or SSRIs, are newer antidepressants that often treat the symptoms of depression more effectively than TCAs and for many people, produce less troublesome side effects.

SSRIs include:

Zoloft (sertraline)

Paxil (paroxetine)

Celexa (citalopram hydrobromide)

Prozac (fluoxetine)

Effexor (venlafaxine)

Luvox (fluvoxamine maleate)

Besides treating depression, SSRIs are sometimes used to treat the symptoms of obsessive-compulsive disorder. Luvox in particular is thought to help patients control their obsessions and compulsions.

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Zoloft (sertraline)

Zoloft is used to treat

• Depression
• Obsessive-Compulsive Disorder (OCD)
• Panic Disorder
• Post Traumatic Stress Disorder (PTSD)

How it works - Zoloft is a SSRI that works by restoring levels of the neurotransmitter serotonin, thereby relieving depression symptoms.

Possible side effects of Zoloft

The following list may not contain all of the side effects associated with this medication:

Most common side effects

• nausea
• diarrhea
• drowsiness
• decreased appetite
• weight loss

Infrequent side effects

• dry mouth
• vomiting
• vaginitis
• insomnia

Rare side effects/Risks

• seizures
• male sexual dysfunction
• increased blood pressure
• hypomania

Before you begin this medication, consult your doctor

If you have kidney or liver disease.

If you are on another antidepressant agent.

If you have a history of seizures.

If you suffer from mania or have suicidal thoughts.

Possible drug interactions

• If you are taking any herbal remedies, vitamins, and/or over-the-counter medications, be sure to tell your physician. The following section offers some, but not necessarily all, of the possible drug interactions.
• Do NOT take Zoloft if you are taking MAOIs or have discontinued taking MAO Inhibitors for less than 14 days; serious, even fatal, interactions have occurred when these medications have been taken together.

Zoloft may increase the effects of:

Valium(diazepam)

Orinase(tolbutamide)

Coumadin(warfarin)

Tagamet (cimetidine) may induce Zoloft toxicity

Tambocor (flecainide) may lead to flecainide toxcititiy.

Norvir (ritonavir) may also lead toxicity.

Antidiabetic drugs taken with Zoloft may increase the risk of hypoglycemic reactions.

Avoid alcohol when taking Zoloft; it is advised in depressed patients to avoid alcohol due to potential adverse reactions.

Overdose

Symptoms of overdose include nausea, vomiting, drowsiness, hyperactivity, and enlarged pupils.

If you think you may have taken an overdose of Zoloft, go to the emergency room or seek other medical attention immediately!

Storage

This drug should be kept in a cool dry area, away from extreme heat or moisture.

Other important information

If you are pregnant, plan to become pregnant, or breastfeeding, discuss the potential risks of this or any medication with your doctor.

Therapy with this agent may increase triglycerides and other lab tests.

Reminders

Keep this and all other medications out of the reach of children

Never share medications with others

Only use this medication as your doctor has prescribed.

Paxil (paroxetine)

Paxil is used to treat

• Depression
• Obsessive-Compulsive Disorder
• Panic Disorder

How it works - Paxil is a SSRI that works by restoring levels of the neurotransmitter serotonin, thereby relieving depression symptoms.

Possible side effects of Paxil

The following list may not contain all of the side effects associated with this medication:

Most common side effects

• lowered blood pressure and fainting upon standing (postural hypotension)
• sweating
• dry mouth
• nausea
• headache
• drowsiness

Infrequent side effects

• nervousness
• insomnia
• constipation
• increase or decrease of appetite
• dizziness
• blurred vision
• abnormal ejaculationimpotence
• sexual dysfunction
• diarrhea

Rare side effects/Risks

• hypomania
• blurred vision
• seizures

Before you begin this medication, consult your doctor

If you have had a history of seizure disorders.

If you have thoughts of death or suicide.

If you have kidney or liver disease.If you have a history of drug abuse.

If you have a history of mania or bipolar disorder.

Possible drug interactions

• Also, if you are taking any herbal remedies, vitamins, and/or over-the-counter medications, be sure to tell your physician. Also make sure that your doctor knows about all prescription drugs that you are taking before starting Paxil.
• Do NOT take Paxil if you are taking MAO Inhibitors or have stopped taking MAO Inhibitors in the last two week; serious, even fatal, interactions have occurred when these medications have been taken together.

Paxil may increase the effects of:

Benzodiazepine

Desipramine

Haldol(haloperidol)

Normodyne(labetalol)

Other possible drug interactions

Dilantin (phenytonin) may result in a decrease of Paxil in the blood thus reducing its effects.

Quinaglute (quinidine) and Tagamet (cimetidine) may increase Paxil levels and may induce toxicity.

Ultram (tramadol) may lead to a risk of seizures.

Tryptophan may result in sweating, nausea, and dizziness when combined with Paxil.

Coumadin ( warfarin) may result in bleeding when taken with Paxil.

Alcohol has not been shown to increase cognitive or motor skills when taken with Paxil; however, alcohol is advised to be avoided when taking Paxil.

Overdose

Symptoms of overdose include nausea, vomiting, tremor, seizure, drowsiness, hyperactivity, and enlarged pupils.

If you think you may have taken an overdose of Paxil, go to the emergency room or seek other medical attention immediately!

Storage

This medication should be kept in a cool dry area, away from extreme heat or moisture.

Other important information

If you are pregnant, plan to become pregnant, or breastfeeding, discuss the potential risks of this or any medication with your doctor.

Paxil levels in elderly patients may be higher than younger ones and may have to be decreased accordingly but no significant difference was found between young and older patients.

Paxil may cause excessive sweating and patients should drink a lot of water or other non-alcoholc beverages when taking this medication.

Reminders

Keep this and all other medications out of the reach of children

Never share your medications with others

Only use this medication as your doctor has prescribed

Celexa (citalopram hydrobromide)

Celexa is used to treat

Depression

Obsessive-Compulsive Disorder (NOT an FDA-approved indication)

How it works - Celexa restores levels of the neurotransmitter serotonin, thereby relieving depression and other related disorders.

Possible side effects of Celexa

The following list may not contain all of the side effects associated with this medication:

Most common side effects

nausea

dry mouth

sleepiness

increase in sweating

low blood pressure

decrease in weight/increased weight

increased appetite

impaired concentration

Infrequent side effects

high blood pressure

hot flashes

dry eyes

arthritis

muscle weakness

Rare side effects/Risks

hyponatremia (low concentration of sodium in blood that often occurs in dehydration)

sexual difficulties (decreased libido

ejaculation disorder and impotence)

Before you begin this medication, consult your doctor

If you have any other medical problems.

If you have kidney or liver problems.

If you have a history of seizures.

If you have a history of drug abuse.

If you have a history of mood disorders, such as mania, or thoughts of suicide.

If you are allergic to medications, foods, or other substances.

Possible drug Interactions

• If you are taking any herbal remedies, vitamins, and/or over-the-counter medications, be sure to tell your physician. The following section offers some, but not necessarily all, of the possible drug interactions.
• DO NOT take MAOIs with Celexa due to possible serious, even life-threatening, interactions that can occur. A period of at least 14 days must pass from the last time an MAO Inhibitor was taken before starting Celexa.

Overdose

Symptoms of overdose include nausea, vomiting, dizziness, sweating, and rapid heartbeat.

If you think you may have taken an overdose of Celexa, go to the emergency room or seek other medical attention immediately!

Storage

This medication should be stored in a cool dry area away from extreme heat or moisture.

Other Important Information

If you are pregnant, plan to become pregnant, or breastfeeding, discuss the potential risks of this or any medication with your doctor.

Older patients may be more sensitive to Celexa than younger patients, and thus may require a lower dosage.

Reminders

Keep this and all other medications out of the reach of children

Never share your medications with others

Only use this medication only as your doctor has prescribed

Prozac (fluoxetine)

Prozac is used to treat

• Depression
• Obsessive-Compulsive Disorder
• Bulimia Nervosa

How it works - Prozac is a SSRI that works by restoring levels of the neurotransmitter serotonin, thereby relieving depression symptoms.

Possible side effects of Prozac

The following list may not contain all of the side effects associated with this medication:

Most common side effects

decreased appetite

weight loss

nausea

altered taste

insomnia

headache

Infrequent side effects

blurred vision

anxiety

nervousness

drowsiness

dizziness

excessive sweating

anorexia

impaired erection

Rare side effects / Risks

hypomania

seizures

tremor

Before taking this medication, consult your doctor

If you have a history of seizure disorder.

If you have severe kidney or liver disease.

Possible drug interactions

• If you are taking any herbal remedies, vitamins, and/or over-the-counter medications, be sure to tell your physician. The following section offers some, but not necessarily all, of the possible drug interactions.
• Do NOT take Prozac if you are taking MAOIs or have discontinued taking MAO Inhibitors for less than 14 days; serious, even fatal, interactions have occurred when these medications have been taken together.

Prozac may increase the effects of:

Valium(diazepam)

Digitoxin/digoxin(digitalis preparations)

Dilantin(phenytoin)

Coumadin(warfarin)

Prozac increases levels of:

Clozaril (clozapine)

Haldol (haloperidol)

Claritin (loratadine)

Dextromethorphan (cough suppressant) and Toradol (ketorolac) may result in hallucinations when taken with Prozac.

Lithium, tryptophan, and Eldepryl (selegiline) may result in drug toxicity.

Ultram (tramadol) may increase seizure risk.

Overdose

Symptoms of overdose include sedation, coma, agitation, violent vomiting, and respiratory depression.

If you think you may have taken an overdose of Prozac, go to the emergency room or seek other medical attention immediately!

Storage

This medication should be kept in a cool, dry area, away from extreme heat or moisture.

Other important information

If you are pregnant, plan to become pregnant, or breastfeeding, discuss the potential risks of this or any medication with your doctor.

Avoid grapefruit juice when taking Prozac due to the increased blood levels of the drug.

Reminders

Keep this medication out of the reach of children

Never share your medications with others

Only use this medication as your doctor has prescribed.

Effexor (venlafaxine)

Effexor is used to treat:

• Depression
• Generalized Anxiety Disorder

How it works - Effexor increases the levels of the neurotransmitters serotonin and norepinephrine.

Possible side effects of Effexor

The following list may not contain all of the side effects associated with this medication:

Most common side effects

headache

insomnia

dizziness

abnormal ejaculation

weakness

neck pain

nausea

weight loss

fast heart beat

increased blood pressure

unusual tiredness

constipation

Infrequent side effects

anxiety/nervousness

blurred vision

diarrhea

dizziness

dry mouth

insomnia

sexual difficulties

difficulty swallowing

Rare side effects/Risks

hypomania

increased blood pressure

seizures

lightheadedness

changes in taste

ringing in ears

mood or behavior changes

ear pain

Before taking this medication, consult your doctor

If you have high blood pressure.

If you have a history of seizures.

If you have heart, liver, or kidney disease.

If you have thoughts about suicide.

If you are allergic to other medications.

Possible drug interactions

• Remember, always follow your physician's recommendations on how to take your medication. Also, if you are taking any herbal remedies, vitamins, and/or over-the-counter medications, be sure to tell your physician.
• Do NOT take MAO Inhibitors while taking Effexor. Potentially serious, even fatal, interactions can occur when these medications are taken together. Wait at least 14 days after ending the use of MAO Inhibitors before beginning Effexor.
• Antidepressants and CNS depressants should be avoided due to an increased sedative effect.
• Cimetidine or Tagament should also be avoided due to major adverse drug interactions.

Overdose

Symptoms of overdose include seizures, rapid heart beat, drowsiness, and confusion. Other symptoms may occur.

If you think you may have taken an overdose of Effexor, go to the emergency room or seek other medical attention immediately!

Storage

Keep this and other drugs in a cool dry area away from extreme heat or moisture.

Other important information

If you are pregnant, plan to become pregnant, or breastfeeding, discuss the potential risks of this or any medication with your doctor.

There seems to be no adverse interactions with alcohol, but due to the possibly adverse effects alcohol may have on a depressed individual, it should be avoided.

Don't discontinue using this drug without consulting your doctor.

Reminders

Keep this and other medications out of the reach of children

Never share medications with others

Only use this medication as your doctor has prescribed

Luvox (fluvoxamine)

Luvox is used to treat

Obsessive Compulsive Disorder

Depression

Panic Attacks

How it works - Luvox works by balancing the levels of a neurotransmitter, serotonin, thereby relieving the symptoms of OCD and depression.

Possible side effects of Luvox

The following list may not contain all of the side effects associated with this medication:

Most common side effects

dry mouth

constipation

anorexia

nausea

insomnia

drowsiness

Infrequent side effects

dizziness

headache

agitation

sleep disorders

delayed or absent orgasm

diarrhea

weakness/loss of strength

Rare side effects/Risks

hypomania

liver toxicity

Before taking this medication, consult your doctor

If you have a seizure disorder, heart, kidney, or liver disease.

If you have had a history of drug dependence or abuse.

If you have had a history of mood disorders or thoughts of suicide.

If you are allergic to any other medication, food or other substance.

Possible Drug Interactions

• If you are taking any herbal remedies, vitamins, and/or over-the-counter medications, be sure to tell your physician. The following section offers some, but not necessarily all, of the possible drug interactions.
• Do NOT take MAOIs when taking Luvox or if you have discontinued taking MAO Inhibitors less than 14 days ago. Serious, even fatal, interactions can occur when taking these medications together.

DO NOT take Luvox when taking

Seldane (terfenadine), or

Hismanal (astemizole)

due to the possible serious heart arrhythmias that may occur when these medications are taken together.

The following medications when taken with Luvox may lead to drug toxicity

• Elavil (amitriptyline), Benzodiazepines, Tegretol (carbamazepine), Tagamet (cimetidine), Anafranil (clomipramine), Clozaril (clozapine), Tofranil (imipramine), Lithium, Maprotiline, Dilantin (phenytoin), and Theophylline.
• Ultram (tramadol) may increase seizure risk
• Tryptophan may cause severe vomiting.
• Coumadin(warfarin) may lead to bleeding.

Luvox stays in the body up to one-quarter less the time in nonsmokers than smokers.

Marijuana smoking may add to the drowsiness effect of Luvox.

Overdose

Symptoms of overdose include nausea, vomiting, dizziness, hyperactivity, slow heartbeat, tremors, abdominal pain, and seizures.

If you think you may have taken an overdose of Luvox, go to the emergency room or seek other medical attention immediately!

Storage

This medication should be stored in a cool dry area, away from extreme heat and moisture.

Other important information

If you are pregnant, plan to become pregnant, or breastfeeding, discuss the potential risks of this or any medication with your doctor.

If nausea and vomiting continue for more than two days after you start taking this medication, call your doctor.

A withdrawal syndrome has been reported if this medication is stopped suddenly so do not stop taking this drug without first talking to your doctor.

Reminders

Keep this and all other medications away from children

Never share your medications with others

Only use this medication as your doctor prescribed