Ssri Medications For Anxiety And Depression

What Is An Ssri

Essentially, SSRIs increase serotonin in the brain. Neural systems affected by increased serotonin regulate mood, sleep, appetite, and digestion. Not surprisingly, the first drugs designed to affect serotonin levels often caused side effects of drowsiness, weight gain, and nausea. Over time, the medications have been refined to better target only specific serotonin receptors . As newer medications are put into the market – first Prozac, then Celexa, now Lexapro – each generation becomes more and more selective in terms of serotonin receptors targeted. Accordingly, the number of side effects has generally been reduced.

This increased flexibility, or neuroplasticity, does not necessarily mean that anxiety will decrease. What it means is that your brain is more capable of making changes that will lead to a decrease in anxiety. You still need to know what to do to promote anxiety-reducing changes in your brain. Monitoring and changing anxiety-producing thoughts is one way to make changes that will reduce anxiety. Another way is to learn ways to respond effectively in anxiety-provoking situations, rather than to avoid them. The SSRIs can often help a person accomplish these kinds of changes.

Are Ssris Safe For Children And Teens

While SSRIs have not been formally approved for use in children and teens in Canada, some are approved in the United States. Your doctor will only prescribe these medications for your child or teen when the potential benefits of using an SSRI outweigh the potential risks of not using them.

SSRIs are NOT addictive.

How Does Ssri For Anxiety Work

Selective serotonin reuptake inhibitors , which were designed to treat depression, are also effective for many anxiety disorders. They have revolutionized the treatment of anxiety, replacing the chronic use of benzodiazepines . SSRIs are effective for OCD, PDs, phobias, PTSD, and GAD. Other antidepressants, including tianeptine, have proven effective in adjustment disorders in which both anxiety and depression are involved. Doses of SSRIs for anxiety disorders could be higher than those used for depression but must be started at lower doses to minimize the short-term agitation sometimes experienced with these medications. The patient should be counseled that side effects often diminish with time and also that empirical switching to another SSRI may be necessary.

SSRIs may also reduce the physiological symptoms of anxiety . Get professional treatment at We Level Up!

BZs are the oldest, class of medications used to treat anxiety. Although they have the advantage of rapid onset of action, they carry the risk of dependence, sedation, and tolerance. Withdrawal syndromes resulting in rebound anxiety, even reactions as severe as delirium tremens, are possible. BZs should be avoided in patients with a past, history of substance abuse, personality disorder, or dosage escalation. These medications are ideal for patients who experience infrequent bouts of anxiety or episodes of anxiety-related insomnia.

You May Like: How To Stop Yourself From Being Depressed

Comorbid Anxiety And Depression

Although the interrelationship between anxiety states and depression has long been recognized in psychiatry, extensive exploration of the clinical significance of this relationship has begun only recently. Data are accumulating to suggest that these 2 conditions occur together even more frequently than they do as distinct clinical entities.58 Some investigators have concluded that these disorders may reflect a continuum of the clinical expression of a single disease. Because patients with chronic anxiety often develop depressive disorders over time, it also has been hypothesized that anxiety disorders actually may be, in some cases, a prodrome for depression.59 Contrasting data suggest that GAD, in particular, is an anxiety disorder that should be considered an independent entity, rather than as a prodrome, residual, or severity marker of depression.60 Nevertheless, the coexistence of anxiety and depression in the same patient negatively affects his or her clinical outcome substantially. Such patients typically have more severe manifestations of these illnesses and respond less robustly to treatment than do patients with either disorder alone.61 Fortunately, with the wide array of new antidepressants available today that can provide robust efficacy, these patients now have access to new agents that can treat both mood and anxiety disorders effectively.

Strategy No : Encourage Cognitive Behavior Therapy

CBT, a form of psychotherapy that is usually short-term and focused on symptom resolution through the observation and change of cognitive distortions and their subsequent behaviors, should be encouraged in patients with panic disorder. The basic premise of CBT is that internal cognitive distortions are linked with maladaptive behaviors , which are then reinforced because this behavior usually temporarily reduces anxiety.19

The gains made with CBT tend to be maintained after the treatment is discontinued, which is generally not the case for pharmacotherapy.10 The high initial cost for the treatment may be offset by savings in the cost of long-term medications. CBT is particularly effective for agoraphobic or avoidance symptoms, an area where medication alone has limited benefit.20 CBT can also reduce the risk of relapse during a medication taper.20 Finally, panic disorder may be refractory to medications alone CBT can be useful in these cases.21

Also Check: Alternative Therapies For Anxiety And Depression

The Search For A Magic Bullet

In the 1970s, second-generation antidepressants were developed with differing receptor-binding activities. They had different side effect profiles, depending on their binding at sites for other classes of receptors .1,2 The realization that more highly receptor-selective agents would reduce the number and type of adverse effects but with increased potency because of their selectivity spurred the development of the class of selective serotonin reuptake inhibitors .

How Long Will My Child Need To Take Medication

The goal of treatment is to fully eliminate all symptoms of depression and anxiety and help your child get back to feeling well every day. It will take at least a few weeks for this to happen, and some symptoms may get better faster than others.

Once the medication is working well, your child or teen will need to stay on the medication for at least 6 to 12 months to help reduce the chance of a relapse. Never stop your childs medication suddenly.

You should only start to reduce your childs medication with the help of your doctor. They will tell you how to decrease the dose slowly and over time. Its best to do this during a period of time that is as stress-free as possible for your child or teen.

Recommended Reading: Is Depression Increasing In The Us

Overview Of Ssri Safety

If you are considering taking SSRIs for your anxiety, it is important to be aware of the risks involved and to use the medication safely. Resort to SSRIs only if therapy and self help do not improve your condition. Ask about SSRIs in liquid form to reduce the likelihood of withdrawal and anxiety recurrence, and avoid combining SSRIs with any other medications or recreational substances to have the safest experience possible.

Was this article helpful?

Doses And Duration Of Treatment

SSRIs are usually taken in tablet form. When they’re prescribed, you’ll start on the lowest possible dose thought necessary to improve your symptoms.

SSRIs usually need to be taken for 2 to 4 weeks before the benefit is felt. You may experience mild side effects early on, but it’s important that you don’t stop taking the medicine. These effects will usually wear off quickly.

If you take an SSRI for 4 to 6 weeks without feeling any benefit, speak to your GP or mental health specialist. They may recommend increasing your dose or trying an alternative antidepressant.

A course of treatment usually continues for at least 6 months after you feel better, although longer courses are sometimes recommended and some people with recurrent problems may be advised to take them indefinitely.

Recommended Reading: Why Am I Depressed When I M Alone

Selective Serotonin Reuptake Inhibitor

Selective serotonin reuptake inhibitors are a class of drugs that are typically used as antidepressants in the treatment of major depressive disorder, anxiety disorders, and other psychological conditions.

SSRIs increase the extracellular level of the neurotransmitterserotonin by limiting its reabsorption into the presynaptic cell. They have varying degrees of selectivity for the other monoamine transporters, with pure SSRIs having strong affinity for the serotonin transporter and only weak affinity for the norepinephrine and dopamine transporters.

SSRIs are the most widely prescribed antidepressants in many countries. The efficacy of SSRIs in mild or moderate cases of depression has been disputed and may or may not be outweighed by side effects, especially in adolescent populations.

When To Consider Taking Ssris

Antidepressants like SSRIs are one method to help ease the symptoms of depression, but theyre typically just part of a treatment plan.

Your doctor may also recommend therapy, and if you chose to go, your therapist may have advice and methods to help you, depending on the severity of your symptoms and your personal history.

Some questions to ask yourself when youre considering SSRIs include:

• Do you feel as though your mental health condition is disrupting your life?
• Do you feel less pleasure when it comes to the things you used to enjoy?
• Do you consistently have trouble concentrating?
• Have you taken antidepressants before? If so, did they help? Were the side effects severe?

If you think you may have depression but arent sure, there are several screening questionnaires that can be helpful. Discussing the results with your doctor is a great first step.

Like SSRIs, serotonin-norepinephrine reuptake inhibitors keep the body from reabsorbing too much serotonin, allowing the brain to use more of it.

But unlike SSRIs, SNRIs also lessen the reuptake of the neurotransmitter norepinephrine.

SNRIs are sometimes used to treat nerve pain and certain anxiety disorders in addition to depression.

Some examples of SNRIs include:

Based on your symptoms and underlying conditions, you and your doctor will decide whether an SNRI or SSRI is the best option for you to try.

Don’t Miss: Depression Support Groups Long Beach Ca

When Shouldnt You Use An Ssri

Before getting into SSRI alternatives, its important to explain why you may not want to use an SSRI if youve been diagnosed with a form of depression or anxiety.

SSRIs are antidepressants. Although most people associate SSRIs with depression, they can actually be used to treat several other conditions, including several common anxiety and mood disorders.

Although most SSRIs are generally safe and effective, theyre not always the best option if you have depression, anxiety or a mood disorder. Common downsides of SSRIs include:

If youre at risk of any of the issues listed above, using an SSRI may not be the most effective option for you. However, if youre currently prescribed an SSRI, you should always check with your healthcare provider before making any changes to your current medication usage.

Finally, some people simply dont find SSRIs effective. Approximately one third of people who use antidepressants notice something known as breakthrough depression a return of their depression symptoms after a period of their medication working normally.

Others simply dont notice an improvement at all. In fact, according to data from Northwestern University, about half of all people who use antidepressants dont experience noticeable relief from depression.

Ongoing Studies Of Atypical Antipsychotic Agents

Additional information on the use of atypical antipsychotic drugs in patients with PTSD is forthcoming. Two studies with quetiapine have been completed, and manuscripts are in preparation.

The first investigation evaluated adjunctive treatment with quetiapine in 80 patients with treatment-resistant, chronic PTSD.53 The patients received 12 weeks of therapy with quetiapine or placebo, and the CAPS score served as the primary efficacy measure. Mark Hamner, MD, Professor of Psychiatry at the Medical University of South Carolina, Charleston, was the principal investigator.

The second study, in which Dr. Hamner also participated, initially assessed the results of 8 weeks of treatment with paroxetine in combat veterans with PTSD.53 A total of 102 non-responders were then assigned to receive 8 weeks of additional therapy with quetiapine. The CAPS score again served as the primary endpoint.

You May Like: Living With A Depressed Spouse

People Who Are Pregnant Or Who May Become Pregnant

Researchers are continuing to investigate the use of mental health medications during pregnancy. The risks associated with taking medication during pregnancy depend on the type of medication and the stage of pregnancy. While no medication is considered universally safe during pregnancy, untreated mental disorders can also pose risks to the pregnant person and the developing fetus.

Pregnant people and health care providers can work together to develop a personalized treatment plan that considers individual needs and circumstances. It is important to weigh the benefits and risks associated with all available treatment options, including psychotherapies, medications, brain stimulation therapies, or a combination of these options. Health care providers may closely monitor a persons physical and mental health throughout pregnancy and, after delivery, pay particular attention to signs of perinatal or postpartum depression.

Certain medications taken during pregnancyincluding some benzodiazepines, mood stabilizers, and antipsychotic medicationshave been linked with birth defects, but the risks vary widely and depend on the specific medication.

Types Of Ssrifor Anxiety

The FDA is in charge of deciding which medications are safe and effective for which reasons. The following SSRIs are approved to treat depression, anxiety, and other mood disorders:

Recommended Reading: How Would A Psychiatrist Treat Depression

Can Antidepressants Give You Suicidal Thoughts

In 2004, the FDA issued a black box label warning for suicidal ideation among 18- to 24-year-olds for common antidepressant drugs. This warning is the FDAs strictest warning for labeling prescription drugs.

The effect of suicidal thoughts is most common with SSRIs, occurring in about 4% of people who take them. However, untreated depression is considered to be much more of a suicide risk than taking antidepressants.

How Do These Drugs Work

Experts initially thought that depression must be caused by low levels of neurotransmitters in the brain, in part because the first antidepressant drug accidentally discovered in the 1950s increased circulating amounts of the chemicals. Further research suggested that serotonin played an especially important role in mood.

This so-called chemical imbalance theory gained a foothold in the cultural psyche and was promoted by ads for the medications.

However, starting in the 1990s, researchers began to understand that depression was much more complicated and that serotonin played only a nominal role. For one thing, SSRIs increase serotonin levels immediately, but it takes several weeks before people start to feel better.

Studies also started to emerge showing that another brain system played a role: People with depression consistently have less volume in an area called the hippocampus thats important for regulating mood.

The current prevailing theory, Hellerstein said, is that chronic stress can cause the loss of connections called synapses between cells in the hippocampus and other parts of the brain, potentially leading to depression.

A paper published earlier this year made headlines for presenting several decades worth of evidence that people with depression dont have less serotonin than people who are not depressed. To most psychiatrists, the paper didnt reveal anything new, and it didnt mean antidepressants arent effective .

Don’t Miss: Anti Depression Meds That Cause Weight Loss

Can You Drink Alcohol On Ssris

While some doctors advise against drinking alcohol while taking SSRIs, many people find it difficult to completely stop their alcohol consumption during treatment.

A key reason doctors advise against drinking is because both SSRIs and alcohol may influence your mood, and may also make you drowsy and less alert.

Its also possible that consuming too much alcohol regularly could disrupt the effectiveness of your SSRIs.

The consensus seems to be: If you want to drink while taking SSRIs, its important to drink in moderation. That means approximately one drink a day for most people, which translates into:

Ssri For Depression And Anxiety: An Overview

Selective serotonin reuptake inhibitors are the most commonly prescribed class of antidepressants. They are effective in treating depression and are also used to treat anxiety, panic disorder, and obsessive-compulsive disorder . SSRIs work by increasing levels of serotonin in the brain. Serotonin is a neurotransmitter that plays a role in mood and anxiety.

Read Also: Signs Of Bipolar Manic Depression