By DR. KOMOROFF Universal Uclick on Sep 9, 2013, at 2:21 AM Updated on 9/09/13 at 5:11 AM
Dear Doctor K: I have been taking an SSRI for years for chronic anxiety. Are there side effects of long-term SSRI use?
Dear Reader: SSRIs (selective serotonin reuptake inhibitors) were created to treat depression, but they also have been a first choice treatment for anxiety disorders since the 1990s. Popular SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil) and sertraline (Zoloft).
SSRIs target the natural brain chemical called serotonin. Serotonin is a neurotransmitter that affects anxiety and mood. Basically, neurotransmitters are the way nerve cells talk to each other.
SSRIs cause more serotonin signals to travel from one brain cell to another. As a result, SSRIs amplify the effects of serotonin on mood and anxiety. SSRIs may indirectly influence other neurotransmitters that also play a role in anxiety. These include norepinephrine and dopamine.
SSRIs are generally safe drugs. A big reason they're popular - with doctors and patients - is that they have fewer and less severe side effects than older anxiety medications. The side effects include insomnia, rashes, headaches, joint and muscle pain, stomach upset, nausea and diarrhea. SSRIs also can diminish sexual desire, performance and satisfaction.
SSRIs can also have dangerous interactions with some other medicines. The most important is an increased risk of bleeding in people who also are using blood-thinning medicines. Blood thinners include aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) and warfarin.
Very rarely, people can develop serotonin syndrome. The symptoms include fever, rapid heartbeat, dilated pupils, agitation, confusion and even coma.
If you have side effects from the SSRI you take, talk to your doctor. Sometimes a person will have a particular side effect from one type of SSRI but not from another.
Write Dr. K at
www.AskDoctorK.com or c/o Universal Uclick, 1130 Walnut, Kansas City, MO 64106
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