SSRIs For Anxiety: Mechanism, Types & Side Effects

Anxiety disorder is a mental health concern that can be indicated by excessive worry, fear, and nervousness. It could also manifest in physical symptoms like muscle tension and rapid heartbeat, impairing your daily routine.

However, there are some of the best treatment options available to manage anxiety symptoms. SSRIs were designed to address depression problems but could also help in reducing anxiety severity.

When used under expert supervision, SSRIs could be a suitable and safe method to treat psychological conditions. SSRIs may help reduce psychological symptoms of anxiety like headache, muscle stiffness, or sleep irregularities.

Are SSRIs also effective for reducing occasional anxiety episodes and suicidal thoughts?

Learning what SSRIs are and how they work may help you understand their working mechanism and cognitive health benefits.

Understanding SSRIs

Selective serotonin reuptake inhibitors are medications used for mental health concerns, including depression, panic disorder, and anxiety.

Approximately 13% of U.S. adults take antidepressants, with higher rates of use among women and people over the age of 60.

SSRIs could help by inhibiting serotonin reuptake, allowing it to accumulate between neurons and facilitating proper messaging between them.

Mechanism Of SSRIs

SSRIs could enhance the function of nerve cells in the brain that regulate emotions. These cells, or neurons, communicate with each other through chemical messengers called neurotransmitters.

People with anxiety may have lower serotonin levels or abnormalities in its function. SSRIs hinder the serotonin reuptake, preventing its reabsorption by the nerve cell that released it.

It may increase serotonin levels in the synaptic cleft, allowing it to bind to receptors on the postsynaptic neuron and regulate mood. It’s essential to understand that SSRIs are selective and do not impact the reuptake of other neurotransmitters.

Types Of SSRIs

1. Citalopram (Celexa)

   Citalopram is a prescribed selective serotonin reuptake inhibitor (SSRI) that treats generalized anxiety disorder (GAD) and may alleviate symptoms of anxiety. As compared to other SSRIs, Citalopram has a higher risk of overdose.

   Citalopram has been associated with a condition called long QT syndrome, which could lead to abnormal heart rhythms. However, it has a lower possibility of interacting with other medications compared to some SSRIs.

2. Fluoxetine (Prozac)

   Fluoxetine or Prozac may help treat OCD and panic disorder. However, Prozac is generally safe for people under the age of 18 and has more interactions with other drugs compared to other SSRIs. Prozac may cause weight loss and agitation. However, it has the least withdrawal symptoms compared to other SSRIs.

3. Fluvoxamine (Luvox)

   Fluvoxamine, also known as Luvox, is prescribed for obsessive-compulsive disorder (OCD). It may help stabilize mood and alleviate symptoms of anxiety by increasing the levels of serotonin. This neurotransmitter regulates mood and anxiety.

   When compared to other SSRIs, fluvoxamine has a higher chance of causing gastrointestinal-related side effects, including nausea, diarrhea, and indigestion. However, the side effects of fluvoxamine are generally mild and tend to improve over time.

4. Escitalopram (Lexapro)

   Escitalopram can be beneficial for people dealing with generalized anxiety disorder. It could enhance mood and reduce elevated stress levels.

   The Food and Drugs Administration has approved Escitalopram. It is also used off-label for treating social anxiety disorder and panic disorder.

   However, Escitalopram may have a higher risk of causing an overdose and cardiac-related side effects, such as long QT syndrome.

5. Paroxetine (Paxil)

   Doctors frequently prescribe Paroxetine for generalized anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), and social anxiety disorder.

   The FDA has revised Paroxetine from Category C (suspected to cause fetal damage) to Category D (evidence of human fetal risk). Therefore, it is advised to take caution when prescribing Paxil to pregnant women.

   Paxil tends to have a more sedative effect than other SSRIs. It can be beneficial for people with anxiety-related sleep disturbances, but it may also cause drowsiness and impair concentration in some cases.

6. Sertraline (Zoloft)

   Sertraline is an antidepressant of the SSRIs class, which can help cure depression and PTSD. It may help restore the balance of serotonin in the brain. Sertraline lets you stay calm and relaxed in tense situations, alleviating heightened stress levels.

   When used as advised, Sertraline may help regulate appetite, mood, and energy levels. However, an excessive dosage of Sertraline might cause diarrhea, headaches, and dry mouth.

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Do SSRIs Cure Anxiety?

SSRIs might be effective in reducing symptoms of anxiety. However, they do not provide a cure for anxiety disorders, as multiple biological, psychological, and environmental factors could contribute to the development and maintenance of anxiety disorders.

Most people with anxiety disorders undergo psychotherapy, such as cognitive-behavioral therapy (CBT). Research shows that the combination of SSRIs and psychotherapy delivers better outcomes in managing anxiety disorders compared to medication alone.

Psychotherapy could help people address the underlying causes of their anxiety, develop healthy coping strategies, and make lasting behavioral changes.

How Long Will SSRIs Take To Work?

SSRIs generally take 2-6 weeks to reach their full effect in reducing anxiety symptoms and stabilizing mood. During this time, you may notice an initial improvement in your sleep, with a gradual reduction in overall anxiety symptoms.

Improvement in these symptoms may take time, as serotonin levels need time to build up and normalize in the brain.

However, It is recommended to take SSRIs for at least 6 to 12 months after encountering improvement in anxiety symptoms. Your healthcare professional will guide you on when it is safe to stop taking them.

How Can You Get SSRIs?

SSRIs are prescription medications, so you must see a medical professional before including these antidepressants in your routine for managing anxiety.

You can make an appointment with a healthcare expert to obtain SSRIs. During the appointment, the doctor will analyze your symptoms and determine if SSRIs suit your condition.

They will take into account factors such as the severity of your anxiety, any other medical conditions you may have, and any medications you are currently taking.

Once your doctor determines that SSRIs are the right course of treatment for you, they will prescribe the medication.

Side Effects Of SSRIs

1. Minor Side Effects

   Some minor side effects of SSRIs may include digestive problems, sexual dysfunction, sleep issues, anxiety symptoms, and physical changes.

   Some people may experience digestive problems such as diarrhea or constipation, as well as loss or gain of appetite, after taking SSRIs.

   Sexual difficulties, low sex drive, erectile issues, or inability to orgasm are other potential side effects associated with SSRI usage. People taking antidepressants can also notice sleep issues such as drowsiness or insomnia.

   Anxiety symptoms, such as agitation and shakiness, could be triggered or intensified by SSRIs. People may also experience physical changes such as blurred vision, dizziness, dry mouth, and nausea.

   Thus, these minor side effects of SSRIs could mimic or worsen symptoms of anxiety and may initially make you feel worse. However, these effects typically subside with continued treatment as the brain chemistry stabilizes.

2. Serious side effects

   • Suicidal thoughts and behaviors: SSRIs carry a boxed warning about the risk of suicidal thoughts, particularly among people under the age of 25. This risk is higher in the first few months of treatment or after a dose change. Thus, you must seek immediate medical help if you or someone you know is experiencing these thoughts.
   • Serotonin syndrome: It occurs when there is an excess of serotonin in the body, which could lead to symptoms such as a rapid heart rate, confusion, and uncontrollable body movements.
   • Abnormal heart rhythm (arrhythmia): SSRIs may increase abnormal heart rhythms, with citalopram potentially carrying a higher risk compared to other SSRIs. Combining SSRIs with medications known to cause arrhythmias can further elevate this risk.
   • Bleeding: Medications that increase serotonin levels, including SSRIs, can raise the threat of bleeding. It is more noticeable when combined with other medications that may cause bleeding, such as NSAIDs.

Timings To Take SSRIs

SSRIs are available in different dosages; your doctor may help you determine the suitable starting dose. If necessary, they may gradually increase the dosage based on your response to the medication.

You can take SSRIs in the morning or at night, depending on personal preferences. It is essential to take them at the same time each day to maintain a consistent level of medication in your system.

However, if you forget an SSRI dose, take it as soon as you remember unless it is close to your next dose. In that case, it is better to skip the missed dose to avoid taking a double dose, which could be dangerous and lead to serotonin syndrome.

What Are SSRIs Used For?

SSRIs are used for various mental health conditions, including:

• Major depressive disorder
• Generalized anxiety disorder
• Panic disorder
• Obsessive-compulsive disorder
• Social anxiety disorder
• Posttraumatic stress disorder
• Premenstrual dysphoric disorder
• Bipolar depression
• Bulimia nervosa
• Treatment-resistant depression

Stopping SSRIs

Although SSRIs are not habit-forming, discontinuing their usage should be done with caution to avoid experiencing withdrawal-like symptoms known as discontinuation syndrome.

Here are some key points to consider:

1. Gradual tapering: It is recommended that the dosage of SSRIs should be gradually decreased under medical supervision. Abruptly stopping SSRIs could lead to discontinuation syndrome, characterized by flu-like symptoms, nausea, dizziness, uneasiness, fatigue, or lethargy.
2. Individualized approach: The decision to stop SSRIs should be based on the person’s specific needs and medical history. To guide the process, the healthcare professional will assess the benefits and risks of discontinuing the medication.
3. Open communication: Maintaining open communication with the healthcare professional throughout the discontinuation process is crucial. Any concerns or changes in symptoms should be shared promptly to ensure appropriate adjustments to the tapering plan.

Frequently Asked Questions

1. Are SSRIs Addictive?
   SSRIs are not addictive. However, sudden discontinuation might cause discontinuation syndrome or a return of anxiety. Thus, gradual dose reduction is recommended.
2. Can SSRIs Be Used as a Standalone Treatment for Anxiety?
   SSRIs can be used as a standalone treatment for anxiety, but they are more effective when combined with therapy. This combination approach addresses both the biological and psychological aspects of anxiety, leading to better outcomes for patients.
3. Do SSRIs Have Any Impact on Weight or Appetite?
   Some people may experience weight gain or loss while taking SSRIs, and changes in appetite are also possible. This impact usually depends on the duration and type of SSRIs you take.
4. Can SSRIs Be Safely Used in Older Adults?
   SSRIs can be safely used in older adults for the treatment of anxiety. However, careful monitoring is necessary due to potential interactions with other drugs and the increased risk of specific side effects.
5. Are There Any Long-Term Impacts or Risks Associated With Taking SSRIs?
   Side effects such as insomnia, headaches, and reduced sexual desire may occur due to prolonged use of SSRIs. There is a slight possibility of increased suicidal thoughts, especially in children and young adults, in the initial days of taking SSRIs.

Conclusion

SSRIs could be considered for tackling panic attacks, sleep issues, and severe muscle stiffness. Consulting the doctor will help you determine the intensity of your anxiety symptoms and the underlying cause triggering it. He might prescribe a suitable SSRI dosage per your need and health history.

However, SSRIs are not a standalone treatment for overcoming your anxiety. Seeking psychotherapy and making a few lifestyle modifications could help enhance your overall mental health.

Meditation and stretching early in the morning might help relax your body muscles and calm your thoughts.

Herbal teas like lavender, holy basil, and green tea may help soothe the nervous system and promote a sense of calmness.

Always take your medication as prescribed, as any change might worsen your situation, and it could make it difficult for your doctor to check if these prescribed medicines are working for your anxiety or not.

Consult a doctor if you are thinking of quitting SSRI, as sudden discontinuation could cause withdrawal symptoms like nausea and uneasiness.