SSRI

Fluoxetine

  • 10-20 mg/day, up to 40 mg/day)


Paroxetine

  • As above  

Sertraline

  • 25-50 mg/day, up to 200 mg/day

Escitalopram

  • 5-10 mg/day, up to 30 mg/day)

Citalopram

  • 10-20 mg/day, up to 40 mg/day

  • SSRI 🡪 ↑ serotonin

  • Depression
  • GAD
  • OCD
  • Neuropathic pain or itch

  • Concomitant MAOI

  • GI: nausea, diarrhea (nausea improves over several days)
  • Sexual dysfunction
  • Insomnia: mainly fluoxetine 
  • Sedation: mainly paroxetine
  • Dose- dependent QT prolongation: Citalopram & escitalopram

Inhibit CYP3A4, & are inhibited by CYP3A4

  • As effective as TCAs in treating depression with better SE profile
  • If no response at 6-8 weeks, should taper & change to a different antidepressant
  • Discontinuation symptoms – Similar to Doxepin