Julie Newman and Andrew A. Nierenberg
The introduction of the selective serotonin reuptake inhibitors (SSRIs) has radically changed the treatment of depression worldwide. The five currently marketed SSRIs, fluoxetine, sertraline, paroxetine, fluvoxamine and citalopram were accepted by international regulatory agencies because these medications were found to be superior to placebo and, at least for most clinical populations, of equal efficacy when compared to the older generations of tricyclic antidepressants (TCAs). The SSRIs are considered to be equally effective for the treatment of depression and share more similarities than differences. Differences in the onset of action has been a subject of debate among the pharmaceutical houses but most clinicians believe that the timing of clinical effect is the same for each of the SSRIs. Similarly, potential differences in side-effects have been exploited by pharmaceutical advertising and marketing-directed research but, again, most clinicians believe that the side-effect profiles of the SSRIs are more alike than different. To clarify the extent of differences and similarities, this chapter will explore the clinically relevant data amongst the five SSRIs.
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Are You Depressed? Heard the horror stories about anti-depressants and how they can just make things worse? Are you sick of being over medicated, glazed over and too fat from taking too many happy pills? Do you hate the dry mouth, the mania and mood swings and sleep disturbances that can come with taking a prescribed mood elevator?