Antidepressants (Selective Serotonin Reuptake Inhibitors - SSRIs)

Question 1

SSRIs: Prescribed for

Answer 1

Depressive illness, post-trau stress, obsessive compulsive disorder

Question 2

SSRIs: Examples

Answer 2

Sertraline, citalopram, fluoxetine

Question 3

SSRIs: Mode of actions

Answer 3

Selectively inhibit the re-upt of serotonin (5-hydroxytryptamine, 5-HT)

Question 4

SSRIs: Contraindications

Answer 4

Poorly-controlled epilepsy

Question 5

SSRIs: Side effects

Answer 5

GIT disturbance, constipation, diarrhoea, insomnia, anxiety, agitation, sexual dysfunction, reduced appetite

SSRIs should never be stopped abruptly! They should be tapered over a few weeks or longer under medical supervision to prevent withdrawal syndrome

Question 6

Serotonin Syndrome

Answer 6

The serotonin syndrome is associated with an excess of serotonin due to therapeutic drug use, overdose or interactions between drugs:

• Although rare, it can be fatal.
• It can occur when two or more drugs affecting serotonin are given at the same time or after one serotonergic drug is stopped and another started.
• Special care is needed when switching from an SSRI to an MAOI (mono amine oxidase inhibitor) or vice versa.
• Symptoms include confusion, disorientation, exaggerated reflexes, abnormal movements, fever, sweating, hypo / hypertension.
• Two important supplements: 5-HTP and St. John’s wort must not be combined with SSRIs as the additive effect significantly increases the risk of serotonin syndrome