Selective serotonin reuptake inhibitors (SSRIs)
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Antidepressants improve mood by affecting the levels of a chemical messenger in the brain (neurotransmitter) called serotonin.
Antidepressants are used to relieve obsessive thoughts and subsequent compulsive behaviours in those who have obsessive-compulsive disorder (OCD).
Research shows that certain antidepressants improve symptoms of OCD and help balance brain chemicals.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
Advisories. Health Canada and the U.S. Food and Drug Administration (FDA) have issued advisories on antidepressant medicines and the risk of suicide. They do not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when doses are changed.
For children and adolescents with OCD, treatment combining cognitive-behavioural therapy with antidepressants (SSRIs), such as sertraline, works better than only taking medicine. Cognitive-behavioural therapy alone also works well, but it works better if it is combined with medicine.2
You may start to feel better within 1 to 3 weeks of taking antidepressant medicine. But it can take as many as 12 weeks to see more improvement. If you have questions or concerns about your medicines, or if you do not notice any improvement by 3 weeks, talk to your doctor. It is possible that one of the medicines will work better for you than another. You may have to try several medicines before you find the right one.
If other mental health problems (such as depression) are present along with OCD, additional medicines (such as a mood stabilizer or an antianxiety or antipsychotic medicine) also may be needed to effectively treat the combined disorders.
Studies have found daily use of SSRIs may increase the risk of bone fracture in adults over age 50. Talk to your doctor about this risk before taking an SSRI.
SSRIs make bleeding more likely in the upper gastrointestinal tract (stomach and esophagus). Taking SSRIs with NSAIDs (such as Aleve or Advil) makes bleeding even more likely. Taking medicines that control acid in the stomach may help.1
Women who take an SSRI during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating OCD.
- Abajo FJ, Garcia-Rodriguez LA (2008). Risk of upper gastrointestinal tract bleeding associated with selective serotonin reuptake inhibitors and venlafaxine therapy. Archives of General Psychiatry. 65(7): 795–803.
- The Pediatric OCD Treatment Study (POTS) Team (2004). Cognitive-behavioral therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: The Pediatric OCD Treatment Study (POTS) randomized controlled trial. Journal of the American Medical Association, 292(16): 1969–1976.
Last Revised: April 5, 2012
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