• Selective serotonin reuptake inhibitors (SSRI's) are used as 1st line treatment for depression. 

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• NICE recommends that a generic form of SSRI's should be used as they are of simlar efficacy to Tricyclic Antidepressants(TCA's), and offer the benefit of less adverse effects. 

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• They are very well tolerated and have the safest overdose profile compared to other classes of antidepressants 

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• Less sedative properties compared to other antidepressant classes ​

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• SSRI's are however associated with a higher incidence of bleeding. Caution should be taken especially in the elderly or anyone taking NSAIDs, and in these cases a gastroprotective formulation is recommended

 

• Examples of SSRI's include : citalopram, escitalopram, fluoxetine, fluvoxamine maleate, and paroxetine     

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• Display a major advantage as they don’t cause drowinsess, cheese reaction,  and less hypertensive risk compared to other antidepressants  e.g. citalopram, sertraline.

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• The most effective of these is deemed to be paroxetine. Adverse effects of SSRIs however have been undermined.

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  30% of patients discontinue treatment due to other side effects, and 50% patients discontinue due to sexual dysfunction.

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