VIDEO
SSRIs (selective serotonin re-uptake inhibitors)
These are newer drugs than tricyclics. They are not more effective – they are equally effective as the older drugs. SSRIs are not potentially lethal in overdose, which is obviously important when someone has had suicidal thoughts. The SSRIs have a different range of side-effects from the tricyclics, and these include:
• Gastric upset, nausea and decreased appetite
• Diarrhoea
• Sleep disturbance (this may be transient or continuing)
• Sexual difficulty (unfortunately, this side-effect can persist through treatment and may be a reason for some to stop the medication)
• Headache (this usually stops after the first week of treatment)
• Excessive sweating
• Increased anxiety levels (initially only – later they decrease anxiety).
Sometimes a short course of a drug like diazepam (Valium) is given to make the onset of treatment more manageable. The diazepam is then stopped.
What happens when you stop an SSRI?
SSRIs, like all other antidepressants, are non-addictive, but a discontinuation syndrome can occur when an SSRI is stopped suddenly. This is more likely to happen with the SSRIs that have a short ‘half-life’, i.e. they are eliminated from the body in a relatively short time. SSRIs which ‘last’ longer are much less likely to do this, e.g. fluoxetine (Prozac).
Discontinuation syndrome can cause dizziness or a feeling of imbalance, tingling in the hands and feet, ’flu-like symptoms and anxiety. Only about one in five people taking these drugs experience it (and very often to an extremely mild degree).
It can happen after missing just one dose of the medication. In order to try and avoid this, keep a spare tablet in your wallet or purse so that, if you forget your morning dose, you can take it later at work or whilst out. Although the discontinuation syndrome is unpleasant, it does not cause any long-term difficulties and rarely poses a big problem.
