This group of medications acts on the brain by causing a relative increase in the neurotransmitter serotonin. The first on the market was flouxetine (Prozac). This was followed by several others. They all work equally well in unipolar depression, but like all antidepressants they can cause a switch from a depressed to a manic/hypomanic or mixed episode in a person with bipolar disorder.
The side effect profiles of the SSRIs are generally favorable, and unlike earlier classes of antidepressants they are much safer in overdose situations. Major complaints include sexual dysfunction in men and women, intense dreams, and irritability.
The SSRIs also have many unique drug-to-drug interactions because of their effects on various liver enzymes. It’s important that if you are on other medications, especially ones that have to be kept at a certain level (like blood thinners, anti-seizure medications, some anti-hypertension medications, etc., that levels are monitored closely when starting, stopping, or changing doses of an SSRI.
