Selective serotonin reuptake inhibitors or SSRIs are a class of antidepressants that are commonly used to treat depression and associated conditions. They became popular in the 1980's as a better alternative to the then popular tricyclic antidepressants (TCAs) that were effective but were more likely to cause adverse effects. They became the antidepressant of choice for children and the elderly who previously reacted with TCAs. Since then, SSRIs have become the most commonly prescribed antidepressant medication to date, thanks to its efficacy.
Mechanism of Action
SSRI's primarily work by altering the activity of serotonin in the brain. Serotonin is a neurotransmitter chemical found in nerve cells that helps to ferry signals or messages between adjacent nerve cells. It is also one of the body’s feel-good chemicals and has been known to induce positive emotion and mood. Once a serotonin molecule has successfully transmitted the signal it was carrying, it is normally absorbed by the nerve cell it was relaying the message to, a process commonly referred to as reuptake.
SSRIs prevent the reuptake of serotonin, which increases the amount of serotonin available for adjacent cells to relay signals. The higher concentration of serotonin in the nervous system has been thought to help with depression, some anxiety disorders, and a number of other mental health issues. SSRIs are also selective for serotonin and usually have no effect on other endogenous neurotransmitters.
Long-term Effects of SSRIs
Effect on Normal Sleeping Patterns
Early studies seemed to indicate that SSRIs had no residual or adverse effects on individuals who used the medication to manage depression and insomnia. However, studies show that people taking SSRIs are more likely to have difficulties falling asleep or being interrupted out of sleep. Additionally, many people taking SSRIs experience delayed and reduced REM sleep, which negatively affects the overall quality of sleep. One study found as much as 22% of individuals taking SSRIs long-term experience one or more types of sleep disturbances, including sleepwalking and nightmares.
People on these prescription medications are also more likely to experience daytime sleepiness, either because of low-quality sleep at night or as a result of the antidepressants.
Increased body weight is one of the most common side effects of SSRI antidepressants, occurring in about 25% of individuals who are on these medications long-term. It is also the leading reason why people change medications or stop using them altogether. Not all SSRIs will cause weight gain, and some lead to more weight gain than others. People who are on SSRIs for less than 6 months are less likely to gain weight.
Increased Risk of Suicide
Many studies carried out over the past few years have found that people taking SSRIs and other antidepressants have a much higher predisposition for suicidal thoughts. Some studies have even found people on antidepressants to be twice as likely to think about suicide as those in a control group. One of the main reasons for this phenomenon is the fact that SSRIs and other medications give the individual physical and mental strength to actually go through with the suicide plan.
An early study for one SSRI, fluoxetine, found that about 1.9% of participants in a trial developed symptoms of sexual dysfunction. However, some studies conducted after the product was launched into the market found high rates of sexual dysfunction, sometimes up to 75% (Ferguson, 2001). Sexual dysfunction is one of the most common effects of long-term SSRI use in both men and women. This condition may manifest in terms of reduced libido and delayed ejaculation and orgasms in men and women respectively.
Coming Off SSRI Antidepressants
Despite their efficacy against depression and other mental health conditions, the adverse effects brought about by SSRI antidepressants lead many people to stop using them, sometimes without consulting a medical practitioner. However, this is a dangerous tendency, since stopping an antidepressant medication without notice can cause serious withdrawal symptoms, which can be fatal.
Discontinuing SSRI medications should be done under the guidance of a doctor, who determines the next course of action after careful assessment. If you have been on one SSRI drug for a long time, they may opt to switch you to another one or wean you off the medication altogether. Sometimes the solution can found by solving the underlying issues that are responsible for the mental problem.
If you do decide to come off SSRIs, a withdrawal aid may make the transition more comfortable. Withdrawal aids such as SSRISupport from VitaminSupport may help keep the withdrawal symptoms at bay while helping nurse your body back to health. It contains B vitamins, L-tryptophan, L-tyrosine, and magnesium citrate that may decrease stress, depression, insomnia, and increase energy. SSRISupport also contains 5-HTP, a key precursor to serotonin that may stabilize the amount of endogenous serotonin in the brain.
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