Selective serotonin reuptake inhibitors (also called SSRIs) are prescription medications intended to treat depression. They function by increasing the level of serotonin, the mood-enhancing chemical that naturally occurs in the body, in the bloodstream. SSRIs and anti-depressants are often viewed as effective, but these medicines have also been linked to promoting aggressive behavior and other negative side effects, including birth defects in infants.
The first and arguably most well-known SSRI was the brand name drug Prozac. It was approved for sale in the United States in 1988, and in combination with its generic counterparts is the third-most-prescribed antidepressant in the country. Research is underway to determine if Prozac is over prescribed as many have speculated, and to examine its connection to adverse side effects. Many individuals who take Prozac experience complications including nausea, insomnia, weakness, sexual dysfunction, and tremors.
Today, there are approximately a dozen different brand name SSRIs in addition to Prozac, including Celexa, Lexapo, Zoloft, Paxil, and Paxil CR. Paxil. Paxil CR is the controlled release version of the drug that releases medication throughout the day or week after just a single dose.
Paxil and Zoloft are among the three most prescribed antidepressants in the country. The latter was introduced to the market in 1991 and has been linked to birth defects, specifically abdominal defects. Paxil was introduced to the US market in 1992 and is approved by the FDA to treat both depression and panic attacks. It is extremely dangerous for women who are nursing or pregnant to use Paxil.
SSRIs are second-generation antidepressants created to treat the disease with fewer side effects than the first-generation antidepressant drugs that were monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants. SSRIs work by increasing serotonin availability in the brain and operate on the basis that depression is caused by a chemical imbalance.
SSRI Side Effects
Despite improvements in antidepressant medications between the first and second generations, SSRIs still produce side effects. Most consider them less severe and also consider SSRIs more effective for a wider group of people. Additionally, SSRIs can be used to treat other mood and anxiety disorders, in addition to depression.
All SSRIs work in a similar manner, supplementing serotonin to the brain. For this reason all also feature many of the same side effects. However, since each drug has a different chemical makeup, each affects individuals in different ways. Essentially, despite their similarities, one SSRI might prove effective for one user, while another might produce negative side effects or have little to no effect at all.
For most users, side effects subside after a few weeks of using the drug. However, for individuals who experience severe side effects, it can be difficult to remain on the drug long enough to see the side effects subside and enjoy the benefits.
The most common side effects of SSRIs include:
- Changes in sexual appetite
- Dry mouth
- Trouble sleeping
- Weight gain or loss
SSRIs are also known to cause thoughts and tendencies related to suicide and self-harm, especially in teenagers.
SSRIs and Pregnancy
There is increasing concern over pregnant women using SSRI medications. The drugs have been linked to birth defects when used during pregnancy.
It’s important that anyone using SSRIs or any type of antidepressant medication not immediately stop using the drug. There are serious withdrawal symptoms associated with abrupt use, so if you believe you might be pregnant or you are attempting to become pregnant, it is essential you discuss the risks associated with SSRIs and work with your doctor to develop a safe and effective plan for stopping use of the drug before pregnancy.
SSRIs and FDA Warnings
Because of the high risk of serious side effects, the FDA now requires SSRIs to feature a black box warning – the agency’s highest alert for medication, just short of being pulled from the market. The black box warning features information about the potential for children using SSRIs to commit suicide.
Currently, there is legal action against Paxil and other SSRI manufacturers. Lawsuits claim use of the drug led to birth defects and the companies did not warn users that the drug was dangerous to use during pregnancy. Paxil’s manufacturer, GlaxoSmithKline has reportedly paid billions dollars to settle several hundred claims related to birth defects. In 2012, the company pled guilty to the United States Department of Justice’s charges of fraud, resulting in $3 billion in civil and criminal fines for alleged unlawful promotion of certain prescription drugs, including Paxil. The manufacturer of Zoloft has faced similar allegations.
Our goal is to ensure people understand the risks associated with SSRIs and that they discuss in detail any concerned they might have about these medications with their doctors.