SSRI for Anxiety (A complete guide)

In this blog, we will discuss SSRI for Anxiety treatment, the most commonly prescribed drugs, side effects, precautions/warnings and additional treatment options for anxiety

What is SSRI for Anxiety?

SSRI for Anxiety treatment includes medicines such as paroxetine (Paxil), escitalopram (Lexapro), sertraline (Zoloft), fluoxetine (Prozac), fluvoxamine (Luvox), and citalopram (Celexa). They are also known as antidepressants, and they are usually prescribed as an Anxiety treatment.

Additionally, the FDA has approved SSRIs to treat depression, anxiety, and other mood disorders (WebMD).

According to Medscape, SSRIs are helpful when treating generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and social phobia. 

Selective Serotonin Reuptake Inhibitors or SSRIs are considered a newer type of antidepressant medication and they have a different chemical structure than the previous cyclic antidepressants, subsequently having different effects in the brain.

They are usually prescribed for several disorders since it is helping to maintain higher levels of the neurotransmitter serotonin, which helps to regulate our mood so this is why they are usually prescribed for depression. 

According to WebMD “SSRIs work by enhancing the function of nerve cells in the brain that regulate emotion. Information is communicated between your brain cells with signals. The chemical messengers that deliver these signals are called neurotransmitters. Serotonin is one type of neurotransmitter”.

Subsequently, neurons send signals to one another releasing a little bit of the chemical messengers (neurotransmitters) and then take it back so they can send the next message, this is also known as “reuptake”. 

Side effects of SSRIs

Every person reacts differently to the use of certain drugs, so it is important to be aware the following symptoms may manifest when using SSRI for anxiety. According to WebMD, here are some of the most common side effects: 

• Insomnia
• Headaches
• Rash
• Blurred vision
• Drowsiness
• Dry mouth
• Agitation or nervousness
• Feeling dizzy
• Pain in the joints or muscles
• Upset stomach, nausea, or diarrhea
• Reduced sexual desire
• Problems with erection or ejaculation

Additionally, children and young adults may be prone to have suicidal thoughts or behavior when being treated with SSRIs. If you have suicidal thoughts or are thinking about hurting yourself while taking SSRIs, it is important to get assistance and support. 

Moreover, if there is too much serotonin in your system due to an overdose or because you are taking other medications that increase serotonin, there is a high risk of developing serotonin syndrome and this could be life-threatening. Seek immediate help if you think you have overdosed. 

If you are taking other medicines while using SSRIs be aware that there could be a dangerous drug interaction. Before starting the SSRI treatment, consult and share with your doctor about any medications or supplements you might be taking. 

It has been suggested that some people do develop side effects while others don’t. In many cases, the side effects tend to disappear within a few weeks but if you notice symptoms that persist or get worse then you should talk to your doctor and check for alternative options. 

How long do SSRIs take to work?

It has been suggested that most people start noticing treatment benefits after 4 to 6 weeks of starting the intake. However, it can take a few months to start feeling the full effects of the medication. 

If you are not seeing any improvements after 6 to 8 weeks, talk to your doctor so he/she can adjust the dosage or the medication. 

Can I stop taking the SSRI medication at any time?

Research has suggested SSRIs are not habit-forming, however, if you stop the medication or miss several doses in a row it can lead to manifesting withdrawal symptoms. According to WebMD, you may start feeling like you have the flu or any of the following symptoms: 

• Nausea
• Dizziness
• Uneasiness
• Fatigue or lethargy

Paroxetine (Paxil)

This is considered an alternative SSRI, a potent inhibitor of serotonin reuptake and a weak effect on norepinephrine and dopamine reuptake. According to Medscape for maintenance dosing, it is recommended: “to make dosage adjustments to maintain a patient on the lowest effective dosage, and periodically reassess the patient to determine the need for continued treatment”. 

Escitalopram (Lexapro)

This is an FDA approved drug for the treatment of generalized anxiety disorder. The mechanism of action is serotoninergic activity potentiation in the CNS resulting from inhibition of neuronal reuptake of serotonin. It has been suggested that the relief of symptoms can start to manifest after 1 or 2 weeks. 

Sertraline (Zoloft) 

This FDA approved drug is prescribed for the treatment of panic disorder, PTSD, social phobia and Obsessive-compulsive disorder. However, it has been suggested to be helpful for other anxiety disorders as well. 

Fluoxetine (Prozac)

Also approved by the FDA to treat OCD and panic disorder, however, it may also be helpful in treating other anxiety disorders. 

Fluvoxamine (Luvox)

This FDA approved drug is helpful to treat Obsessive-compulsive behavior in children aged 8-17 years old and adults however, it may also be helpful in treating other anxiety disorders.

Citalopram (Celexa)

This drug enhances serotonin activity, “Citalopram is a 50:50 racemate of r- and s-citalopram. Reports of dose-dependent QT interval limit dose escalation and coadministration with CYP2C19 inhibitors” (Medscape). 

Selective Serotonin Reuptake Inhibitors vs Serotonin and Norepinephrine Reuptake Inhibitors

We have discussed so far how Selective Serotonin Reuptake Inhibitors work by enhancing the function of nerve cells in the brain that regulate emotion. 

In contrast, Serotonin and Norepinephrine Reuptake Inhibitors are pharmacological agents “with reuptake inhibition of serotonin and norepinephrine such as venlafaxine (Effexor and Effexor XR) and duloxetine (Cymbalta) may be helpful in a variety of mood and anxiety disorders” (Medscape). 

Venlafaxine (Effexor XR)

It is an FDA approved drug prescribed for generalized anxiety disorder, panic disorder and social anxiety disorder in adults, however, it can also be prescribed for other anxiety disorders.

Duloxetine (Cymbalta)

It is usually prescribed to treat generalized anxiety disorder. It is also a potent inhibitor of serotonin and norepinephrine reuptake. 

Are antidepressants the only treatment for anxiety?

According to the article titled “Treatment options for generalized anxiety disorder” from 2008, there are also other treatment approaches that can help you treat your anxiety and let you gain control over your life. 

Generalized Anxiety Disorder is characterized by the fact that there isn’t a specific thing or situation that provokes the intense fear or worry and as it is common, anxiety can be manifested in a range of physical symptoms such as drowsiness, muscle tension, heart palpitations, sweating, panic attacks, among others. 

It has been suggested that anxiety treatments may include relaxation techniques such as progressive muscle relaxation, meditation or even yoga. Additionally, some people also try supplements such as magnesium or herbal sedatives such as valerian, lavender or passionflower. However, even if it is commonly believed they are safer than medication, they can also interact with certain medicines and increase their side effects. 

Psychological treatment

The most studied and believed to be the most effective psychological treatment is Cognitive Behavioral Therapy also known as CBT. 

This type of treatment is not only effective to reduce anxiety symptoms but also symptoms of depression. According to the article, “because CBT involves directly confronting your fears, the therapy itself can sometimes be quite distressing. Generally speaking, the side effects of psychological treatments haven’t been well studied”. 

The general goals of the cognitive approach through CBT include changing thought patterns that trigger anxiety by:

• Identifying cognitive distortions or realizing your fears are irrational and provide you with the tools to challenge them.
• Assessing the consequences of the things or situations that trigger your anxiety.
• Helping you cope with your insecurities and improve your self-esteem. 

Other medications

Besides being prescribed SSRIs or SNRIs to treat generalized anxiety disorder or any other anxiety disorder, there are other treatment options such as:

• Pregabalin: this drug is usually prescribed to treat nerve-related pain but it can also be used to treat generalized anxiety disorder. Studies have shown the effectiveness of this medication but it can often cause dizziness and tiredness.
• Opipramol: this drug is classed as an antidepressant that actually hasn’t been studied as much as the other antidepressants. This is why it gets prescribed on occasion.
• Busperidone: this drug is used to relieve anxiety but it hasn’t been studied as much as the other drugs. However, it is usually prescribed when SSRIs are not well tolerated or haven’t proved to be effective. 
• Hydroxyzine: this is classed as an antihistamine and it is usually prescribed for allergies but it has shown to be effective to treat anxiety but it is used short term and off-label. 
• Benzodiazepines: These are classed as sedatives and can also help relieve some anxiety symptoms. They have been shown to have a fast effect but can create an addiction after just a few weeks of using them. This is the main reason why they are not recommended for the treatment of generalized anxiety disorder. 

Why is this blog about SSRIs for anxiety important?

If you are battling with anxiety and have been recently prescribed an SSRI as part of the treatment is important to know the benefits and the possible side effects. Additionally, being aware of other treatments is also useful so you can have a range of options to finally reduce your anxiety symptoms and regain control over your life.

However, it is important also to consult with your doctor treatment options, side effects and any other questions you may have related to your treatment so you can find the most suitable option that fits your needs. 

Please feel free to comment in the comments section below!

Frequently Asked Questions (FAQs) about SSRI for Anxiety

Recommended reading

• Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressants in Pregnancy and Congenital Anomalies: Population Cohort Study Using Linked Electronic Data in 3 Countries (Euromedicat Project Reports)
• Medications for Anxiety & Depression: A no-nonsense, comprehensive guide to the most common (and not so common) antidepressants and anti-anxiety drugs available
• Dr. Shipko’s Informed Consent for SSRI Antidepressants
• Prozac: Panacea or Pandora? the Rest of the Story on the New Class of Ssri Antidepressants Prozac, Zoloft, Paxil, Lovan, Luvox & More.
• The Pill That Steals Lives: One Woman’s Terrifying Journey to Discover the Truth about Antidepressants

References 

WebMD: What Are SSRIs?

Medscape: Anxiety Disorders Medication

Mayo Clinic

Treatment options for generalized anxiety disorder

Anxieties.com