What SSRI drugs are available?

Among the SSRIs there are some commonly prescribed drugs. These include sertaline, paroxetine, fluoxetine and fluvoxamine. Fluoxetine and fluvoxamine, which are marketed as Fluctin® and Fevarin®, have strong side effects and are therefore rarely prescribed if at all possible.

Sertalin has few side effects and a good therapeutic range. Sertaline is sold as Zoloft®. Zoloft® or its active ingredient, sertaline, is the most potent SSRI.

However, it has relatively few side effects and interacts only rarely with other drugs. These properties make sertaline a frequently prescribed SSRI. The active ingredient is used not only for depression, but also for borderline syndrome and panic attacks.

Paroxetine is marketed as Seroxat®, but the active ingredient causes significantly more side effects than sertaline and influences the efficacy of some other drugs. For example, if paroxetine and hormonal contraceptives are taken at the same time, there is a risk that the contraceptives (contraceptives), such as the birth control pill, will no longer be effective.Fluoxetine is taken in tablet form as Fluctin®, the drug only develops its full effect after it has been exposed to a conversion reaction in the liver. Although Fluvoxamine causes many side effects, sexual dysfunction is very rarely triggered by this drug.

If you are taking SSRI and other drugs at the same time you should always consult your doctor about possible interactions. Special caution should be exercised when taking SSRI and monoamine oxidase (MAO) inhibitors, as both drugs together cause a wide range of interactions. Citalopram, another SSRI agent, is often prescribed.

Drugs that contain citalopram interact only weakly with other drugs and the side effects are also small compared to other drugs. Nevertheless, adverse effects such as excessive sweating, diarrhea or fatigue are not uncommon. Even small amounts of alcohol in combination with citalopram have few side effects.

The effect of citalopram only occurs after one to two weeks, therefore the drug is especially suitable for long-term therapy. Citalopram is mainly used to treat depression, anxiety disorders and panic attacks. The active substance is mostly used as a film-coated tablet, which must be taken once a day.

Citalopram is available only on prescription and must therefore be prescribed by a doctor. Drugs with citalopram should not be discontinued arbitrarily like other SSRIs, because the dose has to be reduced slowly. Otherwise, sometimes severe withdrawal symptoms may occur.

Mirtazapine is also used as an active substance in antidepressant drugs. However, this active substance does not belong to the SSRI group, but is an alpha2-receptor blocker. Alpha2-receptor blockers act on the receptors of the same name.

These are located at the presynapse and normally have an inhibitory effect on signal transmission at the synapse. Thus, the alpha2 receptors usually inhibit the release of messenger substances at the synapse. If this inhibitory mechanism is interrupted, more messenger substances are released, resulting in stronger signal transmission.

Mirtazapine is one of the newer alpha2 receptor blockers. Its favorable side effect profile makes it a frequently prescribed active substance. Undesirable effects that occur nevertheless are phenomena such as severe fatigue, restless legs syndrome, weight gain and anemia.

Agranulocytosis is a more serious complication of mirtazapine treatment. This means a strong to total decrease of granulocytes (granulocytes are white blood cells) in the blood. Effects include fever and constant bacterial infections.

Mirtazapine can be administered in various forms. Mirtazapine is prescribed as a film-coated or enamel tablet for outpatient use outside the clinic; inside the clinic it can also be administered as an infusion. In contrast to SSRIs, mirtazapine begins to work after about a week and patients feel better quickly, which greatly increases their willingness to take the drug regularly.