SSRI
Medications
of the selective serotonin reuptake inhibitor (SSRI) class
have been tremendously successful and have impacted how
we view both mental illness and our society as a whole.
The first, and most well known, medication in this class
is Prozac (fluoxetine). Prozac and the other SSRIs (e.g.,
Zoloft, Paxil, Celexa) have revolutionized our acceptance
of depression as a disease. The incredible success and widespread
use of these medications have made us take a closer look
at ourselves, and how we, as a species, have adapted to
our modern society.
The
SSRIs function much the way as do other antidepressants
in that they change the chemical concentration of neurotransmitters
within the brain. One of the most important aspects of these
medications are their ability to selectively effect serotonin
while leaving other brain chemicals alone. This allows an
effect to occur while minimizing the more serious side effects
seen with other medications that are not selective in their
effect. The chemical structure of Prozac (fluoxetine) is
below.
SSRIs
help not only people with depression but also those with
obssessive-compulsive disorder, bulimia, anxiety, and panic
disorder. SSRIs may cause a decrease in libido and an inability
to attain orgasm in men or women. SSRIs may also disrupt
sleep, causing daytime fatigue. Headaches, sweating, nausea,
slight weight loss, diarrhea, and tremor are some side effects
that may occur in certain patients. SSRIs cause increased
sensitivity to the sun in certain people as well. SSRIs
work by preventing neurons (nerve cells) from pulling in
the serotonin that is floating in the space between neurons.
This allows more serotonin to build up and improves communication
between the neurons.
Over
70% of surveyed depressed and non-depressed people report
that a good sex life is very important to them. Both depression
itself and some of the medications used to treat it may
cause problems in sexual function. People may experience
decreased desire to have sex, erection impairment, ejaculation
impairment, and orgasm delay (in men or women). Psychiatrists
can help by trying non-medication therapies in conjunction,
switching medications, or adjusting dose or scheduling (drug
holiday) of a medication.
