SSRI basics: what they do and who they help
SSRIs (selective serotonin reuptake inhibitors) are a common class of antidepressants. They raise serotonin levels in the brain to ease depression, anxiety, panic attacks, OCD, PTSD, and some forms of chronic pain. You’ve probably heard of names like sertraline (Zoloft), fluoxetine (Prozac), citalopram (Celexa), escitalopram (Lexapro), and paroxetine (Paxil). Each works similarly but can feel different from person to person.
How long until they work and what to expect
Most people start to notice small changes in 1–2 weeks, with clearer benefits after 4–6 weeks. Early effects can be better sleep or more energy before mood lifts. Side effects often show up first — nausea, headaches, sleep changes, or mild anxiety — and usually ease after a couple of weeks. If you don’t feel improvement by 6–8 weeks, talk to your prescriber about dose changes or switching drugs.
Side effects, risks, and interactions
Common side effects include nausea, sexual problems (lower libido or trouble reaching orgasm), weight gain or loss, and sleep changes. Some people feel dizzy or experience tremors. Serious but rare problems include serotonin syndrome (high serotonin signs: high fever, rapid heartbeat, severe confusion) and increased bleeding risk when combined with NSAIDs, aspirin, or blood thinners. Don’t mix SSRIs with MAOIs or St. John’s wort — that can be dangerous. Also be cautious with triptans for migraines; check with your doctor.
If you’re pregnant or breastfeeding, SSRIs have both risks and benefits. Some are safer than others in pregnancy, but untreated depression also carries risks. Talk openly with your clinician to weigh options.
Young people and teens can sometimes experience increased suicidal thoughts when starting an antidepressant. Careful monitoring in the first few months is crucial. Older adults can face low sodium (hyponatremia) or fall risk; start low and go slow.
Stopping SSRIs suddenly can cause withdrawal (discontinuation) symptoms — dizziness, vivid dreams, electric-shock sensations, irritability, or flu-like feelings. Paroxetine and venlafaxine tie to stronger withdrawal. Taper slowly under medical guidance instead of quitting cold turkey.
Practical tips: take the medication at the same time each day, try mornings for stimulating effects or evenings for drowsiness, and give a single medication at least 6–8 weeks to decide if it’s helping. If sexual side effects are a problem, options include dose adjustment, switching to another antidepressant, or adding a drug like bupropion — discuss this with your prescriber.
If side effects feel intolerable or dangerous, call your doctor or go to urgent care. If it’s working but you want to stop, plan a slow taper. SSRI treatment is very individual — what helps one person may not fit another. Keep notes on mood, sleep, and side effects to make your next appointment more useful.
