SSRI Prescriptions Online for Depression Relief

SSRI medication prescriptions for mental health

If you're considering using selective serotonin reuptake inhibitors (SSRIs) as part of your mental health journey, you're not alone. There are millions of people all over the world benefiting from these medications to help treat depression, anxiety, and obsessive-compulsive disorder (OCD).¹

SSRI medications help regulate serotonin levels in the brain, a neurotransmitter linked to mood and overall well-being. Recent research has also shown they help build and strengthen positive neural pathways in the brain over time! You can schedule a same-day appointment with one of our caring, board-certified primary care doctors online.

How do SSRIs work?

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.

SSRIs are a proven medication option for many conditions

Additionally, your doctor may prescribe SSRIs for off-label use, which means using them to address conditions not officially approved by the FDA. Always consult a healthcare professional to determine the appropriate use of SSRIs for your individual circumstances.

Some of the off-label conditions that SSRIs are prescribed for include:

Body dysmorphic disorder

Fibromyalgia

Premature ejaculation

Binge eating disorder

Raynaud's phenomenon

Autism

Menopausal hot flashes

FDA-approved SSRI prescriptions

Selective serotonin reuptake inhibitors (SSRIs) are utilized for many different mental health conditions and come in a wide variety of brand and generic names.

Although they all work by increasing serotonin levels in the brain, there are some differences between SSRI drugs in terms of what they're used for and how they act on each person. Zoloft, for instance, is known to treat a wide range of anxiety disorders as well as depression, making it a preferred option for people managing more than one condition.

Lexapro, on the other hand, is most helpful for major depressive disorders with minimal side effects.

Prozac, one of the oldest SSRIs, has a longer half-life, which makes it helpful for minimizing any potential withdrawal symptoms.

Each SSRI is different, and how they affect each person is also different—that's why it's so important to stay in close touch with your doctor. Our goal is to make it affordable and convenient to get the highest-quality primary care online so you can easily follow up with your doctor any time you need to.

Here's a list of some of the most common SSRIs used for the treatment of depression, anxiety, and various mood disorders:

Sertraline (Zoloft)

Citalopram (Celexa)

Escitalopram (Lexapro)

The FDA has approved SSRIs to treat different conditions, such as:

Panic disorder

Generalized anxiety disorder

Social anxiety disorder

Obsessive-compulsive disorder (OCD)

Bipolar depression

Major depressive disorder (MDD)

Bulimia nervosa

Treatment-resistant depression

Premenstrual dysphoric disorder (PMDD)

Post-traumatic stress disorder (PTSD)

What are the differences between popular SSRIs drugs?

SSRI Drug	Generic Name	Common Dosage	Major Benefits	Common Side Effects
Prozac	Fluoxetine	20-80 mg/day	Effective for depression and anxiety	Nausea, headache, insomnia, sexual dysfunction
Zoloft	Sertraline	50-200 mg/day	Effective for depression, OCD, PTSD	Nausea, diarrhea, sexual dysfunction, insomnia
Lexapro	Escitalopram	10-20 mg/day	Effective for depression and anxiety	Nausea, insomnia, sexual dysfunction, dizziness
Paxil	Paroxetine	20-50 mg/day	Effective for depression, anxiety, OCD	Drowsiness, weight gain, sexual dysfunction, dry mouth
Celexa	Citalopram	20-40 mg/day	Effective for depression and anxiety	Nausea, dry mouth, sexual dysfunction, drowsiness

SSRI common side effects and precautions

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.

Who should exercise special caution with SSRIs?

People who are pregnant, elderly, or experiencing suicidal thoughts should exercise special caution when considering SSRIs and consult with their doctor, as these medications may pose potential risks.

Antidepressants (SSRIs) and weight gain

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

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.

Pros and cons of SSRIs

Pros

Effective in treating depression, anxiety disorders, OCD, and certain other mental health conditions Generally well-tolerated with fewer side effects compared to older antidepressants Non-addictive and typically not associated with abuse potential Improvements in mood and symptoms may be noticed within a few weeks of starting treatment

Cons

Common side effects may include nausea, insomnia, sexual dysfunction, and weight gain Some individuals may experience agitation, restlessness, or increased suicidal thoughts, especially in the early stages of treatmentSSRIs may interact with other medications, including certain painkillers and herbal supplements Abrupt discontinuation of SSRIs can lead to withdrawal symptoms for some individuals, requiring a gradual tapering of the medication under medical supervision

SSRI withdrawal symptoms

SSRIs are not addictive; however, abruptly withdrawing or even missing several doses can lead to withdrawal-like symptoms (discontinuation syndrome). If you are planning to stop your medication, it is essential to work closely with your doctor to gradually and safely reduce your dosage.

Some common withdrawal-like symptoms may include:

A general sense of uneasiness

Nausea

Dizziness

Lethargy

Flu-like symptoms

“Brain zaps”

SSRI Interactions

SSRIs may interact with other medications, increasing the risk of adverse reactions.⁴ Harmful drug interactions often involve combinations of an SSRI with other psychotropic drugs that affect the nervous system, particularly monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, methadone, and clozapine.

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.

SSRI as Part of a Holistic Treatment Plan

Here are other strategies to consider as part of a holistic approach to your mental health journey:

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.

SSRI FAQs

What is the most potent SSRI?

There is no "strongest" option, and different SSRIs come in different dosages. The effectiveness of these medications depends on your individual diagnosis, medical history, symptoms, and brain chemistry. Whereas SSRIs are usually well-tolerated, your doctor may also consider prescribing other options, such as SNRIs or TCASs. Always consult with your doctor for personalized advice.

How do SSRIs make you feel?

SSRIs usually have different side effects depending on the individual. Whereas SSRIs aim to reduce anxiety, improve mood, and enhance emotional well-being, they also come with potential side effects such as sexual changes, initial adjustment periods, and emotional blunting. Always keep open communication with your doctor, as individual experiences vary.

How do doctors decide which SSRIs to prescribe?

Doctors consider different factors when prescribing SSRI medications. These include medical history, symptoms, and individual response to medications. They also consider drug characteristics, such as dosage, onset of action, and flexibility. They might also consider other factors such as the costs involved and patient preferences.

Are SSRIs taken for life?

Whether or not to take SSRIs for life depends on different factors determined by you and your doctor. Long-term use of SSRIs may be beneficial for severe or chronic depression with a high risk of recurrence. However, if you are in remission with no recurrence, have a personal preference to discontinue, or if the side effects outweigh the benefits, stopping SSRIs might be considered. Remember to discuss this with your doctor since there is no one-size-fits-all approach.

Are SSRI drugs addictive?

SSRIs are not addictive, as they don't create compulsive physical dependence. Unlike other addictive substances, SSRIs don't produce euphoria or intense pleasure, and even stopping using them doesn't usually cause severe withdrawal symptoms. SSRIs are only used to manage mental health conditions and not for recreational purposes. They are not considered controlled substances and are safe to use in people with a history of addiction or substance use disorders.

Is bupropion an SSRI drug?

Bupropion (Wellbutrin) is not an SSRI drug.⁵ It belongs to a different medication class called norepinephrine and dopamine reuptake inhibitors (NDRIs). While both SSRIs and bupropion are used in treating anxiety and depression, they affect different brain chemicals and pathways. Your healthcare provider will consider different factors to determine which type of antidepressant works best for you.

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Sources:

PlushCare is dedicated to providing you with accurate and trustworthy health information.

National Institute of Mental Health “Depression” Accessed on February 7, 2024, at https://www.nimh.nih.gov/health/topics/depression
National Library of Medicine, “SSRI treatment suppresses dream recall frequency but increases subjective dream intensity in normal subjects” Accessed on February 7, 2024, at https://pubmed.ncbi.nlm.nih.gov/11422727/
Medline Plus, “Escitalopram” Accessed on February 7, 2024, at https://medlineplus.gov/druginfo/meds/a603005.html
University of Florida Health, Department of Psychiatry College of Medicine, “Medications for OCD” Accessed on February 7, 2024, at https://psychiatry.ufl.edu/patient-care-services/ocd-program/medications-for-ocd/
Stanford Medicine, “Common opioids less effective for patients on SSRI antidepressants” Accessed on February 7, 2024, at https://med.stanford.edu/news/all-news/2019/02/common-opioids-less-effective-for-patients-on-ssri-antidepressants.html
University of California San Francisco, “Interactions between ketamine and prescription antidepressants” Accessed on February 7, 2024, at https://psychedelics.ucsf.edu/blog/interactions-between-ketamine-and-prescription-antidepressants
National Institute of Mental Health, “SSRI Antidepressant Medications: Adverse Effects and Tolerability” Accessed on February 7, 2024, at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181155/
University of Illinois Chicago, “Why do antidepressants take so long to work?” Accessed on February 7, 2024, at https://today.uic.edu/why-do-antidepressants-take-so-long-to-work/
U.S Food and Drug Administration, “Selective Serotonin Reuptake Inhibitors (SSRIs) Information” Accessed on February 7, 2024, at https://www.fda.gov/drugs/information-drug-class/selective-serotonin-reuptake-inhibitors-ssris-information

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SSRI prescriptions online for depression and anxiety