SSRI Antidepressants

Question 1

Sertraline (Zoloft)

Answer 1

Comments: cause diarrheal more commonly than others

Half life: 25hr

Side effects: agitation, akathisia, anxiety, panic, insomnia, diarrhea, GI distress, headache, sexual dysfunction (delayed ejaculation, norgasmia)

Comments: to avoid serotonin syndrome, should not be combined with MAOIs and should be discontinued for at least 5 weeks before starting MAOI

Question 2

Paroxetine (Paxil)

Answer 2

Comments: mildly anticholinergic

Half life: 24hr

Side effects: agitation, akathisia, anxiety, panic, insomnia, diarrhea, GI distress, headache, sexual dysfunction (delayed ejaculation, norgasmia)

Comments: to avoid serotonin syndrome, should not be combined with MAOIs and should be discontinued for at least 5 weeks before starting MAOI

Question 3

Fluvoxamine (Luvox)

Answer 3

Comments: nausea and vomiting more common

Half life: 15hr

Side effects: agitation, akathisia, anxiety, panic, insomnia, diarrhea, GI distress, headache, sexual dysfunction (delayed ejaculation, norgasmia)

Comments: to avoid serotonin syndrome, should not be combined with MAOIs and should be discontinued for at least 5 weeks before starting MAOI

Question 4

Citalopram (Celexa)

Answer 4

Comments: possibly fewer sexual side effects

Half life: 35hr

Side effects: agitation, akathisia, anxiety, panic, insomnia, diarrhea, GI distress, headache, sexual dysfunction (delayed ejaculation, norgasmia)

Comments: to avoid serotonin syndrome, should not be combined with MAOIs and should be discontinued for at least 5 weeks before starting MAOI

Question 5

Escitalopram (Lexapro)

Answer 5

Half life: 27-30hr

Side effects: agitation, akathisia, anxiety, panic, insomnia, diarrhea, GI distress, headache, sexual dysfunction (delayed ejaculation, norgasmia)

Comments: to avoid serotonin syndrome, should not be combined with MAOIs and should be discontinued for at least 5 weeks before starting MAOI

Question 6

Venlafaxine (Effexor)

Answer 6

Comments: SNRI, used to treat GAD and social anxiety

Side effects: anxiety, may increase by at higher doses, headache, insomnia, sweating

Half life: 3.5hr

Side effects: agitation, akathisia, anxiety, panic, insomnia, diarrhea, GI distress, headache, sexual dysfunction (delayed ejaculation, norgasmia)

Comments: to avoid serotonin syndrome, should not be combined with MAOIs and should be discontinued for at least 5 weeks before starting MAOI

Question 7

Duloxetine (Cymbalta)

Answer 7

Comments: SSNRI, used to treat GAD and painful diabetic neuropathy

Half life: 12hr

Side effects: agitation, akathisia, anxiety, panic, insomnia, diarrhea, GI distress, headache, sexual dysfunction (delayed ejaculation, norgasmia)

Comments: to avoid serotonin syndrome, should not be combined with MAOIs and should be discontinued for at least 5 weeks before starting MAOI

Question 8

Fluoxetine (Prozac)

Answer 8

Half life: 1-3 days: avoid in elderly

Side effects: agitation, akathisia, anxiety, panic, insomnia, diarrhea, GI distress, headache, sexual dysfunction (delayed ejaculation, norgasmia)

Comments: to avoid serotonin syndrome, should not be combined with MAOIs and should be discontinued for at least 5 weeks before starting MAOI