SSRI prescriptions online for depression and anxiety

Selective serotonin reuptake inhibitors (SSRIs) are the most prescribed antidepressants, often used as a first-line treatment for depression and other mental health conditions.   

They are effective at treating moderate to severe depression and are generally a safer option, with fewer side effects, compared to other types of antidepressants.   

SSRIs work by influencing serotonin, a neurotransmitter linked to anxiety, mood, and other brain functions. SSRIs block the reuptake or recycling of serotonin around the nerve cells, ultimately increasing its availability in the brain and positively modifying signaling and connections in the brain This leads to reduced stress, improved mood, reduced obsessive thoughts, and improved sleep.  

There are many effective SSRIs, and they vary in their specific dosage, side effects, uses, and other factors.  

While there are some differences, SSRIs have similar side effects, with a few exceptions.  

Fortunately, most people experience only mild side effects, which tend to clear the first few weeks of treatment. Rarely, people will have more significant side effects and may respond better to a different class of medications.  

Some of the side effects include: 

• Dizziness 

• Fatigue or sleep disturbances 

• Nausea or diarrhea 

• Reduced sexual desire, erectile dysfunction, or difficulty reaching orgasm 

• Changes to appetite or weight 

• Heart arrhythmias in those with additional risk factors 

If you're just starting on SSRIs, keep an open line of communication with your doctor. Although it’s rare, some people have serious side effects, even suicidal thoughts as the medications often increase energy and motivation before they decrease depression.Most SSRIs need to be taken daily for 4-6 weeks to notice full effects, though many people notice improvements in symptoms in about 2 weeks.  

Taking your medication with food might help reduce the risk of nausea, and if your medication doesn't interfere with sleep, consider taking it at bedtime to minimize the impact of nausea. Always consult your healthcare provider if any side effects are persistent and won't go away. 

The FDA black box warning on SSRIs suggests a possible increased risk of suicidal thoughts and behaviors in both children and adolescents taking antidepressants.1 This warning was based on studies showing a small but significant correlation between antidepressant use and suicidal ideation in youth. 

Studies show that about 20-30% of people taking antidepressants may experience weight gain, which varies from one person to another.² Weight gain can also occur due to other lifestyle factors not related to medication, and can be related to the effects of depression on activity level and nutrition 

If you notice changes to your weight or if you are concerned about weight gain while taking SSRIs, talk with your doctor about your options. They may include adding a different medication to mitigate weight effects, switching how you take your medication, or changing medications altogether.  

Never stop taking your medication without informing your doctor, even if they are causing you weight gain, since discontinuing SSRIs abruptly can have adverse effects.  

Post-SSRI Sexual Dysfunction (PSSD) is a controversial topic, and there is still research going on. Some people have reported persistent sexual dysfunction after stopping SSRIs³ and have reported symptoms like difficulty achieving orgasm and decreased libido. 

If you experience these symptoms, talk to your doctor. Your doctor may recommend a reduced dose, taking short breaks from your prescription, or other alternative medications. Overall, maintaining a healthy lifestyle, seeking therapy, and managing stress will improve both your physical and mental health, ultimately improving your sexual function.  

Additionally, natural and herbal products can lead to drug interactions with SSRIs. For instance, taking SSRIs with ginkgo biloba can increase the risk of bleeding, including hemorrhage; combining SSRIs with ginseng can trigger serotonin syndrome. 

Some of the medications that can interact with SSRIs include: 

• Antiplatelets - used to prevent blood clots, such as clopidogrel and aspirin 

• Theophylline - used for asthma treatment 

• Lithium - used to treat bipolar disorder and severe depression 

• Clozapine and pimozide - used to treat psychosis and schizophrenia 

• Triptans - such as sumatriptan, naratriptan, and zolmitriptan used to treat migraines 

• Non-steroidal anti-inflammatory drugs (NSAIDs) - common painkillers such as diclofenac, naproxen, and ibuprofen 

• Other antidepressants include tricyclic antidepressants (TCAs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs) 

This list is not exhaustive, and not all interactions apply to every type of SSRI. As such, read the patient information leaflet that comes with your SSRI medication to identify if there are any medications you should avoid. Avoid using alcohol while taking SSRIs, as it can worsen depression and drowsiness symptoms. Fluvoxamine might also amplify the effects of caffeine, leading to symptoms such as restlessness and heart palpitations, so it is recommended to avoid drinking caffeine while on fluvoxamine. 

• Therapy: cognitive-behavioral therapy (CBT) to help you manage negative thought patterns, decrease symptoms from trauma, and develop coping mechanisms 

• Regular exercise, especially outdoors: getting regular physical activity has been shown to decrease symptoms of depression and anxiety, improve sleep, and increase focus. There is additional data that morning sunlight can significantly improve well-being. 

• Consistent sleep: poor sleep is a major trigger for mood disorders including depression, anxiety, psychosis, and suicidality. Waking up at a consistent time, even on weekends or days when you do not work or attend school, can make a big difference in regulating the sleep cycle and improving mood. 

• Nutrition: many people find certain foods help improve mood symptoms, including eating a wide variety of plants and eating fish 

• Mindfulness practices: mindfulness practice has consistently shown to improve mental health, when done consistently. These may include meditation, Taichi or Qigong, yoga, prayer, or intentional periods of being present in the moment without a smartphone or device 

• Depending on your specific needs and diagnosis, you may consider other medications such as different antidepressants, antipsychotics, mood stabilizers, or hypnotics. 

Remember, there isn’t a one-size-fits-all approach, and it's essential to consult your healthcare provider for proper diagnosis and treatment. Treatment will largely depend on your medical history, severity of symptoms, personal preferences, and lifestyle.