The researchers stated that if SSRIs increase suicide risk in some patients, the number of additional deaths is very small because ecological studies have generally found that suicide mortality has declined or at least not increased as SSRI use has increased.
The range of possible mechanisms includes 1 nonspecific neurological effects e. The most commonly reported severe effect following SSRI overdose is serotonin syndrome ; serotonin toxicity is usually associated with very high overdoses or multiple drug ingestion.
A Cochrane review found that at six to nine months, suicidal ideation remained higher in children treated with antidepressants compared to those treated with psychological therapy. Paroxetine may produce discontinuation-related symptoms at a greater rate than other SSRIs, though qualitatively similar effects have been reported for all SSRIs.
However, a review on the ecotoxicology of fluoxetine concluded that at that time a consensus on the ability of environmental realistic dosages to affect the behaviour of wildlife could not be reached. Several studies have suggested that SSRIs may adversely affect semen quality.
One strategy for minimizing SSRI discontinuation symptoms is to switch the patient to fluoxetine and then taper and discontinue the fluoxetine. Wongproposed to retest the series for the in vitro reuptake of serotonin, norepinephrine and dopamine.
It was known at that time that the antihistamine diphenhydramine shows some antidepressant-like properties.
However, the significance of this property is not fully clear. It does, however, delay the reuptake of serotonin, resulting in serotonin persisting longer when it is released. About 1 to 2 babies per babies born in the U. A meta-analysis of drug company data found no evidence that SSRIs increased the risk of suicide; however, important protective or hazardous effects could not be excluded.
A randomized clinical trial performed by the US National Institutes for Mental Health found that fluoxetine reduced acts of domestic violence in alcoholics with a history of such behavior  A second clinical trial performed at the University of Chicago found that fluoxetine reduced aggressive behavior in patients in intermittent aggressive disorder.
SSRI discontinuation syndrome Serotonin reuptake inhibitors should not be abruptly discontinued after extended therapy, and whenever possible, should be tapered over several weeks to minimize discontinuation-related symptoms which may include nausea, headache, dizziness, chills, body aches, paresthesias, insomnia, and electric shock-like sensations.
Serotonin syndrome SSRIs appear safer in overdose when compared with traditional antidepressants, such as the tricyclic antidepressants.
Fluoxetine is not licensed for this use. Sexual dysfunction[ edit ] SSRIs can cause various types of sexual dysfunction such as anorgasmiaerectile dysfunctiondiminished libidogenital numbness, and sexual anhedonia pleasureless orgasm.
The other permitted antidepressants are sertraline Zoloftcitalopram Celexaand escitalopram Lexapro. These syndromes are short-lived, but insufficient long-term data is available to determine whether there are long-term effects. The decline is particularly striking for women who, compared with men, seek more help for depression.
For adults between 25 and 64, the effect appears neutral on suicidal behavior but possibly protective for suicidal behavior for adults between the ages of 25 and Pharmacodynamics[ edit ] Fluoxetine is a selective serotonin reuptake inhibitor SSRI and does not appreciably inhibit norepinephrine and dopamine reuptake at therapeutic doses.
Among adults younger than 25 years, results indicated that there was a higher risk for suicidal behavior. Large doses in rats have been shown to induce a significant increase in synaptic norepinephrine and dopamine.Sertraline Hydrochloride reference guide for safe and effective use from the American Society of Health-System Pharmacists (AHFS DI).
Fluoxetine, also known by trade names Prozac and Sarafem, among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It is used for the treatment of major depressive disorder, obsessive–compulsive disorder (OCD), bulimia nervosa, panic disorder and premenstrual dysphoric disorder.
It may decrease the risk. Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs that are typically used as antidepressants in the treatment of major depressive disorder and anxiety disorders.
The exact mechanism of action of SSRIs is unknown. SSRIs are believed to increase the extracellular level of the neurotransmitter serotonin by limiting its reabsorption .Download