Skip to main content

Selective Serotonin Reuptake Inhibitors

  • Chapter
  • First Online:

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 250))


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 for a more exhaustive review of the SSRIs. Portions of this chapter are adapted with permission from Preskorn et al. (2004).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others


  • Altshuler LL, Cohen LS, Moline ML et al (2001) The expert consensus guideline series: treatment of depression in women 2001. Postgrad Med Special Report, March, pp 1–115

    Google Scholar 

  • Chambers CD, Johnson KA, Dick LM et al (1996) Birth outcomes in pregnant women taking fluoxetine. N Engl J Med 335:1010–1015

    Article  CAS  Google Scholar 

  • Deardorff WJ, Grossberg GT (2014) A review of the clinical efficacy, safety and tolerability of the antidepressants vilazodone, levomilnacipran and vortioxetine. Expert Opin Pharmacother 15(17):2525–2542

    Article  CAS  Google Scholar 

  • Doogan D, Caillard V (1992) Sertraline in the prevention of depression. Br J Psychiatry 160:217–222

    Article  CAS  Google Scholar 

  • Eric L (1991) A prospective double-blind comparative multicentre study of paroxetine and placebo in preventing recurrent major depressive episodes. Biol Psychiatry 29(suppl 11):254S–255S

    Google Scholar 

  • Goldstein DJ (1995) Effects of third trimester fluoxetine exposure on the newborn. J Clin Psychopharmacol 15:417–420

    Article  CAS  Google Scholar 

  • Harvey AT, Preskorn SH (1996a) Cytochrome P450 enzymes: interpretation of their interactions with selective serotonin reuptake inhibitors. Part I. J Clin Psychopharmacol 16:273–285

    Article  CAS  Google Scholar 

  • Harvey AT, Preskorn SH (1996b) Cytochrome P450 enzymes: interpretation of their interactions with selective serotonin reuptake inhibitors. Part II. J Clin Psychopharmacol 16:345–355

    Article  CAS  Google Scholar 

  • Janicak PG, Davis JM, Preskorn SH, Ayd FJ Jr (2001) Principles and practice of psychopharmacotherapy. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  • Madsen H, Enggaard TP, Hansen LL et al (2001) Fluvoxamine inhibits the CYP2C9 catalyzed biotransformation of tolbutamide. J Clin Pharmacol Ther 69:41–47

    Article  CAS  Google Scholar 

  • Preskorn SH (1990) The future and psychopharmacology: potentials and needs. Psychiatr Ann 20(suppl 11):625–633

    Article  Google Scholar 

  • Preskorn SH (1995b) Should rational drug development in psychiatry target more than one mechanism of action in a single molecule? Int Rev Psychaitry 7:17–28

    Article  Google Scholar 

  • Preskorn SH (1996) Clinical pharmacology of selective serotonin reuptake inhibitors. Professional Communications, Caddo.

  • Preskorn SH (1999a) Defining “Is”. J Pract Psychiatry Behav Health 5:224–228.

    Google Scholar 

  • Preskorn SH (1999b) Outpatient management of depression. Professional Communications, Caddo.

  • Preskorn SH, Ross R, Stanga CY (2004) Selective serotonin reuptake inhibitors. In: Preskorn SH et al (eds) Antidepressants: past, present and future. Springer-Verlag, New York, pp 241–262

    Chapter  Google Scholar 

  • Shad MU, Preskorn SH (2000) Antidepressants. In: Levy RH, Thummel KE, Trager WF, Hansten PD, Eichelbaum M (eds) Metabolic drug interactions. Lippincott Williams & Wilkins, Philadelphia, pp 563–577

    Google Scholar 

  • Trintellix (vortioxetine) [package insert] (2017) Lundbeck, Deerfield

    Google Scholar 

  • Viibryd (vilazodone hydrochloride) [package insert] (2010) Trovis Pharmaceuticals LLC, New Haven

    Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Dee Lochmann .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lochmann, D., Richardson, T. (2018). Selective Serotonin Reuptake Inhibitors. In: Macaluso, M., Preskorn, S. (eds) Antidepressants. Handbook of Experimental Pharmacology, vol 250. Springer, Cham.

Download citation

Publish with us

Policies and ethics