Selective Serotonin Reuptake Inhibitor
Generic and Trade Names
Citalopram Celexa Fluoxetine Prozac Fluvoxamine Luvox Paroxetine Paxil Sertraline Zoloft
These agents are used primarily as antidepressants. The mechanism of action appears to be by inhibition of neuronal serotonin uptake. They are useful for several psychiatric disorders, including: depression, obsessive compulsive disorder, and panic attacks. (Facts and Comparisons 1999)
Hydration: insure adequate fluid intake unless directed otherwise.
Electrolytes should be maintained (tendency for hyponatremia) (Facts and and Comparisons 1999)
Caloric intake (tendency for anorexia). (Pronsky 1999)
Monitor sugar levels, especially in diabetics, these agents can alter sugar balances. (Facts and Comparisons 1999)
Avoid tryptophan (supplements have been banned but it is present in some foods). (Facts and Comparisons 1999)
Avoid alcohol (Naranjo, Threlkeld).
Melatonin may help improve sleep used together with these agents in depressed individuals. (Dolberg 1998)
St. John's Wort may dangerously intensify the effects of SSRI antidepressants (Demott 1998), (Gordon 1998).
Tobacco can increase the metabolism of fluvoxamine by 25%. (Facts and Comparisons 1999)
Kava may theoretically increase the effects of SSRI drugs. (Facts and Comparisons, 2000)
Demott K. St. John's wort tied to serotonin syndrome. Clinical Psychiatry News 1998;26:28.
Dolberg OT, Hirschmann S, Grunhaus L. "Melatonin for the treatment of sleep disturbances in major depressive disorder." Am J Psychiatry, Aug. 1998; 155(8):1119-121.
Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 1999.
Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000.
Gordon JB. SSRIs and St. John's wort: possible toxicity? Am Fam Physician 1998;57:950.
Naranjo CA, Pouos CX, Bremner KE, Lanctot KL. Fluoxetine attenuates alcohol intake and desire to drink. Int Clin Psychopharmacol 1994;9:163-72.
Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Selective Serotonin Reuptake Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparison, Apr 1997.
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