Selective serotonin reuptake inhibitors

In recent decades, a multitude of studies have shown that there are a series of effective drugs to increase the effect of different interventions by reducing the intensity or frequency of certain symptoms. This is the case of the selective serotonin reuptake inhibitors (SSRIs)mainly used in the treatment of depression.

You’ve probably heard of some selective serotonin reuptake inhibitors. These drugs are presented under the name citalopram, escitalopram, fluoxetine, paroxetine, sertraline, etc.. Do any look familiar to you?

Selective serotonin reuptake inhibitors is a label that encompasses a series of drugs with a common goal. Typically they have been used as antidepressants in the treatment of depressive symptoms, anxiety disorders and some personality disorders.

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However, SSRIs are not the only antidepressants that exist. Antidepressant drugs were introduced into clinical use in psychiatry starting in 1957. In the subsequent decade, most of the so-called tricyclic antidepressants (TCA) were developed. At the same time, monoamine oxidase inhibitors (MAOIs) also began to be used.

Tricyclic antidepressants achieve remission or improvement of depressive symptoms in more than 65% of cases. Nevertheless, Its side effects are also numerous.. This represents a disadvantage compared to other antidepressants.

Antidepressant drugs, unlike stimulants (amphetamines, methylphenidate…), They only improve mood in people who are previously depressed. They do not raise mood in subjects without depression.

What antidepressant drugs exist?

The main types of antidepressants Currently used are the following:

Tricycles (ADT). They are named so because of their chemical structure.Selective serotonin reuptake inhibitors (SSRIs). They group together various principles with different chemical structures. They act on presynaptic serotonin receptors, selectively inhibiting its reuptake.Selective serotonin and norepinephrine reuptake inhibitors (SNRIs). They non-selectively inhibit presynaptic serotonin and norepinephrine receptors at the same time.Irreversible (MAOI) and reversible monoamine oxidase inhibitors (RIMA). They inhibit the enzyme monoamine oxidase, responsible for the metabolization of biogenic amines.Noradrenergic and selectively serotonergic (NaSSA). They give rise to an increase in norepinephrine and serotonin in the intersynaptic space.Selective norepinephrine reuptake inhibitors (SNRIs). Its action is fundamentally limited to norepinephrine.Selective dopamine reuptake inhibitors (SSRIs). They target dopamine.

In this article we will focus on selective serotonin reuptake inhibitors (SSRIs). But first, let’s see what serotonin is.

Serotonin, the neurotransmitter that makes us feel good

Serotonin is a chemical substance produced by the human body, which transmits signals between nerves, functioning as a neurotransmitter. It is considered by some researchers as the chemical substance responsible for keeping our mood balanced, so a serotonin deficiency would lead to depression.

Serotonin has a general modulating and behavioral inhibitory effect. This neurotransmitter affects most brain functions. You could say that Serotonin is the “pleasure hormone”, in addition to being the “mood hormone”.

Serotonergic function is fundamentally inhibitory. It influences sleep and is also related to moods, emotions and depressive states.. It affects vascular function as well as the frequency of the heartbeat.

There is a close relationship between depression and serotonin. However, scientists are still not sure whether decreased serotonin levels contribute to depression, or, on the contrary, depression causes decreased serotonin levels.

How do selective serotonin reuptake inhibitors work?

SSRIs block the reuptake (reuptake) of serotonin. Thus, serotonin levels increase between neurons in the intersynaptic space, which produces a downregulation of 5HT1A receptors. After the reduction in the number of 5HT1A receptors, the neuron is “uninhibited” to release more serotonin into the synaptic space.

This increase in serotonin levels in the intersynaptic space (synaptic cleft) can improve a person’s mood. Additionally, SSRIs are called selective because they primarily affect serotonin, and not other neurotransmitters.

Not all that glitters is gold

All selective serotonin reuptake inhibitors work in a similar way.. As with all medications, there are certain side effects that are common, which does not mean that they necessarily have to appear during treatment.

In fact, some of the side effects may disappear after the first few weeks of treatment, while others may cause your doctor to decide to change the treatment. If you can’t tolerate one SSRI, you may be able to tolerate another, as its chemical composition varies.

Since all that glitters is not gold, Possible side effects of SSRIs may include, but are not limited to:

Drowsiness.Nausea.Dry mouth. Insomnia.Diarrhea.Nervousness, agitation or restlessness.Dizziness.Sexual problems, such as decreased sexual desire or difficulty reaching an orgasm or inability to maintain an erection (erectile dysfunction).Headache.Blurry vision.

As we have seen, Selective serotonin reuptake inhibitors are drugs specially designed for depression.. However, they may have other indications (long-term treatment of anxiety and obsessive-compulsive disorder).

These drugs are not free of side effects., although they are lower than in other antidepressants, such as MAOIs or ADTs. If you think you may need medication, the first thing you should do is visit your doctor. Remember that self-medication can be very dangerous.

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