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Selective serotonin reuptake inhibitors and adverse effects: A narrative review
Neurology International
  • Amber N. Edinoff, Louisiana State University Health Science Center
  • Haseeb A. Akuly, Louisiana State University Health Science Center
  • Tony A. Hanna, LSU Health Sciences Center - Shreveport
  • Carolina O. Ochoa, Louisiana State University in Shreveport
  • Shelby J. Patti, Louisiana State University in Shreveport
  • Yahya A. Ghaffar, Louisiana State University in Shreveport
  • Alan David Kaye, Louisiana State University Health Science Center
  • Omar Viswanath, University of Arizona College of Medicine – Phoenix
  • Ivan Urits, Louisiana State University in Shreveport
  • Andrea G. Boyer, MUSC College of Medicine
  • Elyse M. Cornett, Louisiana State University in Shreveport
  • Adam M. Kaye, University of the Pacific
ORCiD
Adam M. Kaye: 0000-0002-7224-3322
Document Type
Article
DOI
10.3390/neurolint13030038
Publication Date
9-1-2021
Abstract

Depression is the most prevalent psychiatric disorder in the world, affecting 4.4% of the global population. Despite an array of treatment modalities, depressive disorders remain difficult to manage due to many factors. Beginning with the introduction of fluoxetine to the United States in 1988, selective serotonin reuptake inhibitors (SSRIs) quickly became a mainstay of treatment for a variety of psychiatric disorders. The primary mechanism of action of SSRIs is to inhibit presynaptic reuptake of serotonin at the serotonin transporter, subsequently increasing serotonin at the postsynaptic membrane in the serotonergic synapse. The six major SSRIs that are marketed in the USA today, fluoxetine, citalopram, escitalopram, paroxetine, sertraline, and fluvoxamine, are a group of structurally unrelated molecules that share a similar mechanism of action. While their primary mechanism of action is similar, each SSRI has unique pharmacokinetics, pharmacodynamics, and side effect profile. One of the more controversial adverse effects of SSRIs is the black box warning for increased risk of suicidality in children and young adults aged 18–24. There is a lack of understanding of the complexities and interactions between SSRIs in the developing brain of a young person with depression. Adults, who do not have certain risk factors, which could be confounding factors, do not seem to carry this increased risk of suicidality. Ultimately, when prescribing SSRIs to any patient, a risk–benefit analysis must factor in the potential treatment effects, adverse effects, and dangers of the illness to be treated. The aim of this review is to educate clinicians on potential adverse effects of SSRIs.

Creative Commons License
Creative Commons Attribution 4.0 International
Citation Information
Amber N. Edinoff, Haseeb A. Akuly, Tony A. Hanna, Carolina O. Ochoa, et al.. "Selective serotonin reuptake inhibitors and adverse effects: A narrative review" Neurology International Vol. 13 Iss. 3 (2021) p. 387 - 401 ISSN: 2035-8385
Available at: http://works.bepress.com/adam-kaye/156/