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The role of Serotonin Reuptake Inhibitors in the treatment of psychiatric illness: an update.

Article Excerpt
Even though there have been advances in pharmacotherapy for depression beyond Selective Serotonin Reuptake Inhibitors (SSRIs), they remain the mainstay for treatment of depression, especially since many are now available in generic form. They are used also for a variety of anxiety disorders, and one is indicated for bulimia nervosa and premenstrual dysphoric disorder

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Selective Serotonin Reuptake Inhibitors (SSRIs) have been on the market since 1987 (when fluoxetine was introduced) and have subsequently dominated market share. They have largely replaced tricyclic antidepressants and monoamine oxidase inhibitors due to their favorable side effect profile and their ease of titration to therapeutic doses, not to mention escaping the lethality of tricyclics in overdose. SSRIs are thought to work by blocking reuptake ofserotonin. They appear to function at low doses, which frequently turn out to be their therapeutic doses--a huge advantage over their predecessors. Most clinicians believe that the members of the SSRI class are equally effective in large populations, yet responses may vary considerably with each medication in individual patients. One misconception is that these medications are more effective than their predecessors, which is not true. Rather, they tend to be utilized more because of the advantages just mentioned. Interestingly, some researchers and clinicians have noted that tricyclics and MAOI drugs may be more effective in severe depression than the SSRI class. In general, new antidepressant research has moved on to compounds with other mechanisms of action.

As a group, SSRIs are most often used to treat depression but some members of the family have other indications including post traumatic...

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