Handouts · Medications
SSRIs (Selective Serotonin Reuptake Inhibitors)
Includes fluoxetine, sertraline, escitalopram, citalopram, paroxetine, and fluvoxamine. These are first-line medicines for depression and anxiety.
What This Group Is
SSRIs gently raise serotonin, a brain chemical that steadies mood, worry, and sleep.
They treat depression, anxiety, panic, OCD, and PTSD. They are not addictive, but they do take 4–6 weeks to reach full effect.
How to Take It
Take once daily, usually in the morning. If it makes you sleepy, an evening dose may suit you better.
Taking it with food helps if you feel queasy at first. Try to take it at the same time each day.
Black Box Warning
Antidepressants can rarely increase suicidal thoughts in people under 25, especially in the first weeks or after a dose change.
This does not mean the medicine is dangerous for most people — but you and your family should watch closely early on and call right away if mood, agitation, or dark thoughts worsen.
Common (Usually Mild) Side Effects
- Nausea, loose stools, or headache — often fade in 1–2 weeks.
- Trouble sleeping or feeling drowsy.
- Sexual side effects (lower desire, delayed orgasm) that can persist — tell us, there are options.
- Feeling jittery or restless early on.
Serious — Call Us or Seek Care
- Serotonin syndrome: agitation, sweating, shivering, fast heartbeat, twitching — usually when combined with other serotonin drugs.
- Low sodium (more common in older adults): confusion, weakness, headache.
- Easy bruising or bleeding, especially if you also take aspirin or NSAIDs.
- New or worsening suicidal thoughts, or a sudden “high”/racing mood.
Alcohol & Interactions
Limit or avoid alcohol — it can deepen depression and add to drowsiness.
Tell your prescriber about all supplements (especially St. John’s Wort), triptans, tramadol, and other antidepressants.
Monitoring
No routine blood tests are needed for most people.
We’ll check in often in the first month to track your mood and side effects. Older adults may have sodium checked if symptoms appear.