Selective Serotonin Reuptake Inhibitors

Abstract

The first antidepressants were created by chance but brought the idea that central serotonin agonism produced an antidepressant effect. SSRIs were the first class of psychotropic medications to be rationally designed, meaning that researchers intended to utilize a specific mechanism of action while avoiding adverse effects. In this way, SSRIs were created to be safer and more tolerable than previous antidepressants. SSRIs share many similarities, but differ in terms of pharmacokinetics and effects on CYP450 enzymes, which is detailed in this chapter. Further information will be provided regarding safety, clinical indications/uses, and dosing recommendations.

The goal of this textbook is to briefly review the older and established treatments for depression and focus more on newer treatments and future directions of the field. The book contains an extensive chapter on STARD, which reviews the efficacy of SSRIs. Additional chapters cover proposed biomarkers as they relate to SSRI efficacy and safety including genetic markers. The reader is referred to those chapters as well as additional resources including Preskorn.com for a more exhaustive review of the SSRIs. Portions of this chapter are adapted with permission from Preskorn et al. (2004).