Chemicals in your brain affect the way you
feel. When you have
post-traumatic stress disorder (PTSD) or
depression, you may not have enough of a chemical
called serotonin. Selective serotonin reuptake inhibitors (SSRIs) raise the
level of serotonin in your brain.
SSRIs often are used to treat all the
symptoms of PTSD, as well as other conditions like depression or
anxiety. These medicines also treat the sleep problems
you may have with PTSD.
Studies have shown that SSRIs improve symptoms of non-combat–related PTSD when compared with a placebo. Some studies are mixed about whether SSRIs work as well for veterans with combat-related PTSD.2
SSRIs can help more types of
symptoms than other medicines can.
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
or other emergency services right away if you have:
Call your doctor if you have:
Common side effects of this medicine include:
The U.S. Food and
Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk with your doctor about these possible side effects and the warning signs of suicide.
The FDA has issued a warning about taking triptans, used for headaches, with SSRIs
(selective serotonin reuptake inhibitors) or SNRIs (selective
serotonin/norepinephrine reuptake inhibitors). Taking these medicines together
can cause a very rare but serious condition called serotonin syndrome.
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)
Never suddenly stop taking antidepressants. The use of any
antidepressant should be tapered off slowly and only under the supervision of a
doctor. Abruptly stopping antidepressant medicine can cause negative side
effects or a relapse of symptoms.
SSRIs can be safer than tricyclic or tetracyclic
antidepressants, because they do not cause death if taken in large quantities
(overdose). SSRIs usually are well tolerated and effective. SSRIs also may be
safer for older adults, because the side effects are more tolerable.
People with liver
disease usually require lower doses of SSRIs.
Studies have found
that daily use of SSRIs may increase the risk of bone fracture in adults over age
50. Talk with your doctor about this risk before taking an SSRI.
bleeding more likely in the upper gastrointestinal tract (stomach and
esophagus). Taking SSRIs with NSAIDs (such as Advil or Aleve) makes bleeding
even more likely. Taking medicines that control acid in the stomach may
SSRIs are also used to
treat depression. SSRIs alone are not commonly used if you have episodes of
mania, such as in
Sexual dysfunction can be a
significant problem for some people while taking an SSRI. A medicine such as
sildenafil (Viagra) may help both men
and women who have sexual problems caused by SSRIs.1, 4
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Women who take an SSRI during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating your PTSD.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Lam RW, et al. (2009). Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults: III. Pharmacotherapy.
Journal of Affective Disorders, 117(Suppl 1): S26–S43.
Benedek DM, et al. (2009). Guideline Watch: Practice Guideline for the Treatment of Patients With Acute Stress Disorder and Posttraumatic Stress Disorder. Arlington, VA: American Psychiatric Association. Available online: http://focus.psychiatryonline.org/article.aspx?articleid=52871.
Abajo FJ, Garcia-Rodriguez LA (2008). Risk of upper gastrointestinal tract bleeding associated with selective serotonin reuptake inhibitors and venlafaxine therapy. Archives of General Psychiatry, 65(7): 795–803.
Nurnberg GH, et al. (2008). Sildenafil treatment of women with antidepressant-associated sexual dysfunction: A randomized controlled trial. JAMA, 300(4): 395–404.
January 9, 2013
Adam Husney, MD - Family Medicine
& Jessica Hamblen, PhD - Post Traumatic Stress Disorder
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