Selective Serotonin Reuptake Inhibitors are a class of antidepressants also known as SSRIs. They work by blocking the reuptake of the chemical serotonin, leading to increased serotonin levels in the brain. This mechanism is thought to alleviate symptoms of depression and anxiety by enhancing serotonin signaling and regulating mood. They include but are not limited to the following:

Citalopram (Celexa)

Escitalopram (Lexapro)

FLUoxetine (Prozac)

FluvoxaMINE

PARoxetine (Paxil)

Sertraline (Zoloft)

Vortioxetine (Trintellix)

Vilazodone (Viibryd)

Refer to your medication bottle to know how often you should take your medication. Do not take a higher dose or more often than prescribed. Seek medical attention IMMEDIATELY, by calling 911, if you take too much of your medication.

When starting an antidepressant, it is important to note that sometimes the full benefit of the medication can’t be felt until a few weeks after starting the medication. However, the side effects can start right away. Side effects can decrease or go away as you continue with the medication but if any of the side effects don't go away or are causing significant problems, contact your doctor.

It is important to not stop taking your SSRI without first talking to your healthcare provider. When stopping an antidepressant medication, your healthcare provider will help you decrease your dose over several weeks. Stopping an SSRI too quickly may cause serious symptoms including anxiety, feeling restless, changes in sleep habits, headache, sweating, nausea, dizziness, electric shock-like sensations, shaking, and confusion.

SSRIs can be taken with or without food. If it causes stomach upset on an empty stomach, try taking it with food to see if that helps. You should not drive, operate heavy machinery, or do other dangerous activities until you know how your medication affects you. Do not drink alcohol while you take SSRIs.

Specific to the oral solution, it should be noted that it must be diluted before use. However, it shouldn’t be mixed until you are ready to take it. When ready, it should only be diluted in water, ginger ale, lemon/lime soda, lemonade, or orange juice. The solution may look cloudy or hazy after mixing, this is normal.

If you miss a dose of your medication, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of your medication at the same time.

The most common side effects associated with antidepressants are

nausea, loss of appetite, diarrhea, or indigestion

tremor or shaking, increased sweating

agitation or anxiety

change in sleep habits including increased sleepiness or insomnia

sexual problems including decreased libido and ejaculation failure

feeling tired or fatigued

It is important to note that some antidepressants are more likely to cause certain side effects than others for each individual. If your side effects are causing significant problems, you can contact your doctor to consider switching to a different medication.

If you have questions or concerns about taking Zoloft with a previously prescribed medication or over-the-counter medication or supplement, contact your pharmacist. Within the class of SSRIs there is a number of potential drug interactions. We will only cover a few in this video. However, be sure that your doctor who prescribed the medication as well as your pharmacy are aware of all medications - prescription and over-the-counter that you take. This will allow them to check for drug interactions. Do not take an SSRI if you have been taking the antipsychotic medicine pimozide (Orap®). This combination can cause serious heart problems.

If you are taking other medications that increase levels of serotonin such as antidepressants, lithium, fentanyl, the antinausea medication Zofran, or tramadol, among others as well as over-the-counter medications such as St. John’s Wort, you should monitor for Serotonin Syndrome

Symptoms associated with serotonin syndrome may include the following combination of signs and symptoms: mental status changes (e.g., agitation, hallucinations, delirium, and coma), autonomic instability (e.g., fast heart rate, changes in blood pressure, dizziness, sweating, flushing, increased body temperature), neuromuscular symptoms (e.g., tremor, shaking, rigidity, incoordination), seizures, with or without gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea). If symptoms of serotonin syndrome occur, discontinue ondansetron and contact a doctor immediately.

Do not take an SSRI if you are currently taking a monoamine oxidase inhibitor (MAOI) or have taken one within the last two weeks. Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including certain antidepressants and the antibiotic linezolid. If you do take an SSRI close in time to taking an MAOI, it can cause serious side effects. Get medical help right away if you have any of these symptoms: high fever, rapid changes in heart rate or blood pressure, uncontrolled muscle spasms, confusion, stiff muscles, loss of consciousness.

If you have certain medical conditions, it can be dangerous to take an SSRI. Contact your doctor if you have any of the following:

Liver, heart, or kidney problems

History of bipolar disorder, mania, seizures, or convulsions

History of low sodium levels in your blood or high blood pressure or bleeding problems.

If you are pregnant, planning to become pregnant, or breastfeeding, contact your primary care doctor to make sure it is okay to take an SSRI.

SSRIs have been associated with increased suicidal thoughts and behaviors in children, adolescents, and young adults. It is important to monitor for clinical worsening and suicidal thinking and behavior.

Accidental ingestion of medicine, especially by children, can result in a fatal overdose. Never give anyone else your prescription medication. Keep your medicine secure, out of sight and reach of children, and in a location not accessible by others, including visitors to your home.

To dispose of unwanted, unused or expired medications, contact your local police station or visit www.fda.gov/drugdisposal for information about drug-takeback programs.

To dispose of unwanted, unused or expired medications, contact your local police station or visit www.fda.gov/drugdisposal for information about drug-takeback programs.