Generalized Anxiety Disorder and SSRIs

Selective serotonin reuptake inhibitors (SSRIs) are a class of pharmacological antidepressants. They are currently the most popular class of antidepressant medications because of their relative safety in comparison to monoamine oxidase inhibitors (MAOIs) and tricyclics (TCAs). In addition to being prescribed for depression, SSRIs are sometimes prescribed for General Anxiety Disorder as well.

Selective serotonin reuptake inhibitors (SSRIs) affect the concentration of the neurotransmitter serotonin, which plays a role in anxiety. Serotonin is a neurotransmitter with calming effects, and oftentimes people with anxiety do not have adequate amounts of serotonin. Thus, although they are considered antidepressants, SSRIs have been used effectively for the treatment of anxiety disorders.

Improvement is usually seen in four to six weeks after beginning treatment.

Common names include:

• Citalopram (Celexa)
• Fluvoxamine (Luvox)
• Paroxetine (Paxil)
• Fluoxetine (Prozac)
• Sertraline (Zoloft)
• Escitalopram (Lexapro)

Read more details about SSRIs.

Possible side effects of SSRIs include:

• Drowsiness
• Dryness of mouth
• Blurred vision
• Nausea
• Dizziness
• Difficulty sleeping
• Sexual dysfunction
• Risk of severe mood and behavior changes
• Suicidal thoughts and actions

Gastrointestinal upset is the most common side effect that users experience. These include nausea, diarrhea, and cramping. It is commonly recommended that users take SSRIs with food and an antacid or antiemetic for the first 2-3 weeks of treatment.

SSRIs also activate the central nervous system, which can result in agitation, anxiety, restlessness, and insomnia.

FDA issued a warning that combining an SSRI with one of the commonly-used "triptan" medications for migraine headaches can cause serious side effects such as agitation, hallucinations, elevated body temperature, and rapid changes in blood pressure. (6)

Other side effects can include headache, dry mouth, excessive sweating, tremor, and sexual dysfunction.

Do not take selective serotonin inhibitors (SSRIs) with monoamine inhibitors (MAOIs).

The first SSRI on the market was fluoxetine (Prozac). The newer agents are: citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft).⁸ They all share the same side effects but in varying degrees. Unlike TCAs, they interact very little with other receptors besides the serotonin 5-HT reuptake receptor. Their side effects tend to be related to increased serotonin activity: nausea, gastrointestinal upset, sweating, anxiety, insomnia, headache, restlessness, and sexual dysfunction. This class of drugs is prescribed for mild to moderate depression.⁸