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Selective Serotonin Re-Uptake Inhibitors - Precautions

Abstract: What must I know and think about when I take/prescribe SSRIs?

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Selective Serotonin Re-Uptake Inhibitors - Precautions

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Written by: Petros Skapinakis, MD, MPH, PhD, lecturer of Psychiatry in the University of Ioannina Medical School, Greece. Eva Gerasi, postgraduate student in the Department of Psychiatry, University Hospital of Ioannina, Greece.
First version: 22 Jul 2008.
Latest revision: 29 Jul 2008.

What must I know and think about when I take/prescribe SSRIs?

Answer:

Selective serotonin reuptake inhibitors (SSRIs) can take 4 to 8 weeks to start working, although they may be effective much sooner. They should not be taken within 2 weeks of stopping MAOIs, or with some other medicines or with alcohol which may reduce their effectiveness and increase their toxicity. SSRIs can be safer than tricyclics because they do not cause death if taken in large quantities. They are also safer for older adults because the side effects are more tolerable.

Sexual dysfunction can be a significant problem for some people while taking an SSRI. If this side effect occurs, another antidepressant (such as bupropion which is less likely to cause serious sexual dysfunction) may be used instead.

Never suddenly stop taking SSRIs (or any other antidepressant).

Their use should be tapered off slowly and only under the supervision of a doctor. Abruptly stopping SSRIs (or generally antidepressant medications) can cause negative side effects or a relapse into another depressive episode.

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