Saturday, June 13, 2009

SSRIs


Low serotonin, 5-HT, levels have reportedly been associated with depression. Because Mind Hacks has already written a concise and interesting article on the low-serotonin myth, I will direct you there for more information on the hypothesis.

Selective serotonin reuptake inhibitors work by preventing nerve cells in the brain from reuptaking serotonin, which is released into the synapse between communicating nerves, thereby leaving more serotonin available for brain function and neurotransmission.

SSRIs include: Fluoxetine (Prozac), Paroxetine (Paxil, Seroxat), Escitalopram (Lexapro, Cipralex), Citalopram (Celexa), Sertraline (Zoloft), Fluvoxamine (Luvox).

These medications may also be used to treat other disorders such as anxiety, insomnia, sexual dysfunction, OCD, phobias, panic disorder, and eating disorders.

There is hesitation about the use of SSRIs in treating children and pregnant women. Concerns over the degree to which increased risk of suicidal behaviours occurs in adolescents are being researched. In regards to pregnancy, “both continuous SSRI exposure and continuous untreated depression were associated with preterm birth rates exceeding 20%.” (2) Additional research has found negative effects on growth and the possibility of increased hypertension and preeclampsia (3).

While SSRIs are reportedly better tolerated than other types of antidepressants, side effects include:
• Nausea, loss of appetite, diarrhoea.
• Anxiety or irritability.
• Problems sleeping or drowsiness.
• Loss of sexual desire or ability, sexual dysfunction.
• Headaches or dizziness.
• Weight gain.

Discontinuation of SSRIs should be done slowly and under the supervision of a physician. Withdrawal symptoms can be quite intense and include: shock-like electrical activity in brain, dizziness, sweating, nausea, vertigo, insomnia, and tremors.

An article in the Journal of Psychiatry and Neuroscience (1) reviews and discusses important non-pharmacological approaches to manipulating serotonin levels including induced mood changes, meditation, light-therapy, exercise, and diet.

References: 1, 2, 3, 4

No comments:

Post a Comment