Selective serotonin reuptake inhibitor

Selective serotonin reuptake inhibitors (SSRIs) are a <a href="/facts/Class_of_drugs/CegnN5Yr">class of drugs</a> that are typically used as <a href="/facts/Antidepressant/N62ND3Fa">antidepressants</a> in the treatment of <a href="/facts/Major_depressive_disorder/l2lQeWqr">major depressive disorder</a>, <a href="/facts/Anxiety_disorder/wh9zFH1V">anxiety disorders</a>, and other psychological conditions.
SSRIs primarily work by <a href="/facts/Reuptake_inhibitor/vsrPEUXF">blocking</a> serotonin reabsorption (reuptake) via the <a href="/facts/Serotonin_transporter/VPh5wtCy">serotonin transporter</a>, leading to gradual changes in brain signaling and receptor regulation, with some also interacting with <a href="/facts/Sigma-1_receptor/qje6l9GW">sigma-1 receptors</a>, particularly <a href="/facts/Fluvoxamine/1wmv6FLh">fluvoxamine</a>, which may contribute to cognitive effects. Marketed SSRIs include six main antidepressants—<a href="/facts/Citalopram/qepx3XJy">citalopram</a>, <a href="/facts/Escitalopram/qoCbRxWA">escitalopram</a>, <a href="/facts/Fluoxetine/U28lM3Pm">fluoxetine</a>, <a href="/facts/Fluvoxamine/1wmv6FLh">fluvoxamine</a>, paroxetine, and <a href="/facts/Sertraline/SBk6L0Jr">sertraline</a>—while <a href="/facts/Dapoxetine/0Fpl3afK">dapoxetine</a> is indicted for <a href="/facts/Premature_ejaculation/SFCHo2KE">premature ejaculation</a>. Fluoxetine has been approved for veterinary use in the treatment of <a href="/facts/Separation_anxiety_in_dogs/LEMI0vaz">canine separation anxiety</a>.
SSRIs are the most widely prescribed antidepressants in many countries. Their effectiveness, especially for mild to moderate depression, remains debated due to mixed research findings and concerns about <a href="/facts/Bias/geuh5KrE">bias</a>, <a href="/facts/Placebo/3fw50t53">placebo</a> effects, and <a href="/facts/Adverse_effect/vAhfbr1J">adverse outcomes</a>. SSRIs can cause a range of side effects, including movement disorders like <a href="/facts/Akathisia/hFUb0Uqr">akathisia</a> and various forms of sexual dysfunction—such as <a href="/facts/Anorgasmia/RxDBIR6J">anorgasmia</a>, <a href="/facts/Erectile_dysfunction/7HDetsos">erectile dysfunction</a>, and <a href="/facts/Hypoactive_sexual_desire_disorder/umg46Hl0">reduced libido</a>—with some effects potentially persisting long after discontinuation (<a href="/facts/Post-SSRI_sexual_dysfunction/L6jjcmEH">post-SSRI sexual dysfunction</a>). SSRIs pose <a href="/facts/Drug_interaction/T5VcSVGd">drug interaction</a> risks by potentially causing <a href="/facts/Serotonin_syndrome/PqLvx901">serotonin syndrome</a>, reducing efficacy with <a href="/facts/Nonsteroidal_anti-inflammatory_drug/coIkzl4s">NSAIDs</a>, and altering drug metabolism through <a href="/facts/Cytochrome_P450/alxusFD0">CYP450</a> enzyme inhibition. SSRIs are safer in overdose than <a href="/facts/Tricyclic_antidepressant/vpBLER2Q">tricyclics</a> but can still cause severe toxicity in large or combined doses. Stopping SSRIs abruptly can cause withdrawal symptoms, so tapering, especially from <a href="/facts/Paroxetine/FIR7QqMP">paroxetine</a>, is recommended, with <a href="/facts/Fluoxetine/U28lM3Pm">fluoxetine</a> causing fewer issues.
Positive antidepressant trial results are much more likely to be <a href="/facts/Publication_bias/Wbmr1WjW">published</a> than negative ones, and many <a href="/facts/Meta-analysis/IcfChd8z">meta-analyses</a> have conflicts of interest due to <a href="/facts/Pharmaceutical_industry/5mCITYys">pharmaceutical industry</a> involvement, often downplaying potential risks. While warnings about antidepressants possibly causing suicidal thoughts were added after years of debate, the evidence has remained controversial, with some experts questioning the strength of the link even after regulatory actions.

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Selective serotonin reuptake inhibitor