On today's episode of real-life pharmacology, I'm going to talk about selective serotonin re-uptake inhibitors,

commonly known as SSRIs. They are an incredibly common class. They are the first-line drug,

if we're going to use a drug, for treatment, management of depression. They're also used in anxiety, PTSD, OCD, and a variety

of different mental health concerns. Example medications are Cetalopram, brand name Calexia, Certraline is Zoloft, peroxatein is

Paxil, fluoxetine is Prozac, and fluvoxamine is Louvox, and S-Catalopram is Lexapro.

As far as the side effect profile goes, this can be a little bit challenging.

You may find some that cause a little more activation, some that cause more sedation.

GI side effects are probably the most common adverse effect.

You may see some nausea, you may see some diarrhea, for example. And more specifically,

these agents do vary a little bit between one another, but I have seen all of these issues

kind of happen with all of them. So it kind of is a lot of patient-specific reactions that you might see.

Generally, there's a tendency for certrchraline, which is sometimes coined the term squirtreline,

may be a little more serotonergic and may cause a little more loose stools or diarrhea.

Again, this is probably a dose-dependent effect where as we get to higher doses, you may be more likely to see that happen.

Paroxetine may not be quite as well tolerated in the elderly patients.

There may be some anticholinergic activity there.

So that's one that you might see that we try to avoid in our geriatric patient population.

It may be a little bit more sedating as well and maybe have a higher propensity of

causing weight gain, which can be certainly problematic for some patients.

Looking at satalopram, brand name Selexa, there are some adverse effects we need to keep in mind here. One is an

association with QTC prolongation and we also have a really common drug interaction as far as patients

being on omeprosol.

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