PEBC: What You Need to Know: Selective Serotonin Reuptake Inhibitors (SSRIs)

Examples: citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline


Indications: depression, anxiety


Dosing: most SSRIs can be dosed once daily - may split dose into twice daily for tolerance purposes (nausea)


Adverse Effects:

-nausea, vomiting

-constipation, dry mouth (paroxetine)

-diarrhea (sertraline)

-insomnia (fluoxetine)

-drowsiness (paroxetine, fluvoxamine)

-weight gain

-sexual dysfunction

-anxiety during initiation

-QT prolongation (escitalopram, citalopram)


Drug Interactions:

-NSAIDs - increased risk of stomach bleed

-SNRIs, triptans - increased risk of serotonin syndrome

-monoamine oxidase-A inhibitors - hypertensive crisis risk - wait 14 days after MAOI discontinuation before starting an SSRI

-paroxetine and fluoxetine are CYP2D6 inhibitors

-fluvoxamine is a CYP1A2 inhibitor

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