Selective serotonin reuptake inhibitors (SSRIs) learning module - main section

5. Key points


By working through this module, you will have acquired an understanding of the principal risks of SSRIs and how the risks can be managed. The following is a quick reminder of the important points covered:

  • SSRIs are licensed for depressive illness. Some are also licensed for other indications including anxiety disorders, obsessive–compulsive disorder and bulimia nervosa
  • Clinical response to SSRIs usually occurs within two weeks, maximal response usually within four to six weeks
  • Adverse effects of SSRIs such as headache, nausea, and anxiety/agitation are very common at the start of treatment; these effects often resolve spontaneously. Withdrawal reactions also occur frequently
  • Sexual side effects occur frequently but may not be volunteered by the patient
  • Rare but life-threatening adverse effects include serotonin syndrome (medical emergency), haemorrhage, convulsions, hyponatraemia and psychiatric disorders (mania, suicide risk)
  • Important drug interactions include serotonergic agents (especially MAOIs, linezolid, ‘triptan’ antimigraine drugs, tramadol), antiplatelet drugs, anticoagulants, and NSAIDs
  • As with other antidepressants the activating effects of SSRIs may lead to an increase in motivation before any mood-lifting effects occur, so close attention to suicide risk is advised especially in the early weeks of treatment
  • SSRIs are generally safer in overdose than other classes of antidepressant medicine.

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Page last modified: 17 February 2015