SSRI Tag

09 Jul

Posted at 14:29h in Pharmacology

Mental Health Notice: If you are experiencing significant depression, anxiety, or thoughts of self-harm, please speak with a qualified healthcare professional. You can contact the 988 Suicide & Crisis Lifeline by calling or texting 988 (24/7), or the Crisis Text Line by texting HOME to 741741. In a life-threatening situation, call 911.

Selective serotonin reuptake inhibitors (SSRIs) are among the most commonly prescribed medications for managing conditions like depression and anxiety. Drugs such as fluoxetine and sertraline work by increasing serotonin levels in the brain, helping regulate mood and emotional stability.

While SSRIs are generally effective, their success often depends on how they are used. Many individuals unknowingly make mistakes that can reduce effectiveness or increase side effects. Understanding these pitfalls is essential for achieving better mental health outcomes. For a deeper look at how SSRIs are being studied in clinical contexts, see this research overview on SSRI prescribing patterns and considerations for older adults.

[caption id="attachment_74889" align="aligncenter" width="500"]mistakes-ssris-pexels Photo by Ivan Babydov[/caption]

06 Aug

Posted at 13:53h in Addiction, Mental Health Research
[caption id="attachment_62745" align="alignleft" width="130"] Luke Cavanah[/caption] Luke Cavanah, BS Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, PA 18509     MedicalResearch.com: What is the background for this study? Response:  “Selective” serotonin reuptake inhibitors (SSRI) are a class of medications that are first-line treatments for many anxiety, depressive, and other psychiatric disorders.1–3 Despite their name, SSRIs often have activity on other receptors and chemicals.4 One such SSRI that is known for being particularly nonselective is paroxetine.5 Paroxetine’s mechanisms of action are summarized in the figure below which shows binding not only to the serotonin transporter (SERT) but also to the norepinephrine transporter (NET), nitric oxide synthetase (NOS), the muscarinic (M1) receptor, and the liver cytochrome 2D6 enzyme. Paroxetine’s receptor promiscuity, especially its anticholinergic activity, can contribute to unfavorable adverse effects.5 Older adults (65+) are particularly vulnerable to some of these adverse effects. The American Geriatrics Society (AGS) regularly publishes an explicit list, called the Beer’s List, of what they call “potentially inappropriate medications (PIMs)”, which are medications they recommend avoiding in this demographic when having certain disorders/conditions or most clinical contexts. The AGS Beers Criteria, in 2012, 2019, and most recently in 2023, has identified paroxetine as a PIM due to its strong anticholinergic activity and high risk of sedation and orthostatic hypotension, and thus they recommend it should be avoided in this population in most circumstances.6–8 Given the recommendation against the use of paroxetine in older adults, we were interested in examining the utilization of paroxetine by U.S. Medicare beneficiaries. Medicare patients primarily consist of people 65+ and cover 94% of non-institutionalized people in this age group.9