What Meds

Psychiatric Medications


SSRI'S—SELECTIVE SEROTONIN REUPTAKE INHIBITORS
Celexa (Citalopram), Luvox (Fluvoxamine), Paxil (Paroxetine), Prozac (Fluoxetine), Zoloft (Sertraline)

Serotonin reuptake inhibitors are a group of chemically unique antidepressant drugs.These drugs are effective in depression, bulimia nervosa, obsessive compulsive disorder, anorexia nervosa, panic disorder, pain associated with diabetic neuropathy and for premenstrual syndrome.There is limited controlled research on the use of SSRIs in children for the treatment of psychoactive disorders. This limited experience makes it difficult to determine whether SSRIs are appropriate therapies in children, and if so, at what dose and for what length of therapy. Side effects were mostly mild, and the most frequent side effects were headache, vomiting, insomnia, and tremor. SSRIs have also been studied in the treatment attention-deficit/hyperactivity disorder (ADHD). The side effects caused by SSRIs in adolescents varied widely. Some of these side effects include motor restlessness, sleep disturbances, social disinhibition, mania or hypomania, and psychosis. The most common side effects that were experienced include hypomania-like symptoms, irritability, gastrointestinal upset, and insomnia.

As physicians gain experience with the use of SSRIs in clinical practice, and as the results of larger, well-designed controlled clinical studies become available, a more comprehensive understanding of the role of these drugs in childhood psychiatric disorders will emerge.

General SSRI Information:

Why is this drug prescribed?
Prozac is the only SSRI which is FDA-approved for treatment of  depression in children and adolescents 8-17 years old. It is also indicated for OCD in children and adolescents 7-17 years old.

Sertraline is approved for OCD in children 6-17 years old.

Please see each specific SSRI for FDA-approval indications.

How much of this drug is typically used?
Please see each specific SSRI for formulations and dosing strengths.

Adverse Reactions
SSRI’s may cause the following reactions:

Rarely:

Specific Web Sources:

Fluoxetine - RxList: http://www.rxlist.com/cgi/generic/fluoxetine.htm
Factsheet on antidepressant used in the treatment of depression and bulimia includes both clinical and patient information.

Prozac (Fluoxetine) - PSYweb: http://www.psyweb.com/Drughtm/fluoxe.html
Offers advice on living with this serotonin-specific drug used to treat depression. Lists side effects, proper dosage, and cautions.

Research about Fluoxetine: http://www.mentalhealth.com/drugrs/f33-p05.html
Fluoxetine (Prozac) Research The medication research files have been updated. 1995-1999 by Phillip W. Long, M.D.

Zoloft - Sertraline Hydrochloride: http://www.fairlite.com/ocd/medications/zoloft.shtml
Full product information designed for professionals on this antidepressant medication. Includes detailed list of adverse effects.

Sertraline (Zoloft) - Monograph: http://www.parkinsons-information-exchange-network-online.com/drugdb/121.html
Find comprehensive and easy-to-understand patient info, in narrative form, from Parkinson's list. Topics include side effects and proper dosage.

Sertraline (Zoloft) - PSYweb: http://www.psyweb.com/Drughtm/sertra.html
Patient guide to living with this drug used to treat depression, social phobia, panic attacks, and OCD lists side effects, dosage, and precautions.

Sertraline - RxList: http://www.rxlist.com/cgi/generic/sertral.htm
Factsheet on drug used to treat depression. Incudes clinical studies and information on dosage, dependence, and drug interactions.

Research about Sertraline: http://www.mentalhealth.com/drugrs/f33-z02.html
Sertraline (Zoloft) Research.

Paxil (Paroxetine) - PSYweb: http://www.psyweb.com/Drughtm/paxoxe.html
Patient guide to living with this antidepressant used to treat OCD, social phobia, neuropathy, and premature ejaculation.

Paroxetine - RxList: http://www.rxlist.com/cgi/generic/parox.htm
Factsheet on orally administered antidepressant includes patient information, clinical pharmacology, and the results of recent clinical studies.

Paroxetine - Parkinson's List: http://www.parkinsons-information-exchange-network-online.com/drugdb/097.html
Patient oriented description of medicine used primarily to treat depression. Also provides information on side effects and drug interactions.

Paxil (Paroxetine Hydrochloride):
http://www.sb.com/prescribing_information/2000.cgi?drug=px&from=../products/
&fromname=Products+and+Services:+United+States+Pharmaceuticals

Manufacturer's US prescribing information for antidepressant indicated in the treatment of major depressive episodes and panic disorders.

Luvox (Fluvoxamine) - PSYweb: http://www.psyweb.com/Drughtm/luvox.html
Includes advice on this drug, which is used to treat depression, eating disorders, and chronic tension headaches. Lists side effects, proper dosage, and precautions.

Fluvoxamine - Luvox Rx List: http://www.rxlist.com/cgi/generic/fluvox.htm
Detailed product information for the professional including full prescribing information, precautions, and list of all brands available.

Luvox (Fluvoxamine) - FAQs: http://www.druginfonet.com/faq/faqluvox.htm
Topics include side effects, Luvox and weight gain, and the drug's indication for treatment of bulimia and depression.

Fluvoxamine Maleate - RxList Monographs: http://www.rxlist.com/cgi/generic/fluvox.htm
Descriptions, clinical pharmacology, indications, dosage, and administrations supplied. Also warnings, contraindications, precautions, adverse reactions, drug interactions and over dosage information.

Citalopram - RxList: http://www.rxlist.com/cgi/generic/citalo.htm
Find full prescriber info and a patient information leaflet on this antidepressant medication. Also provides cost and pharmacological details.

Efficacy of Citalopram for Depression: http://www.mastermind1.com/wwwfreelance/celexa/index37.htm

Research Studies and Use in Child Psychiatry
Fluoxetine is the only SSRI with FDA-labeling for treatment of depression in children and adolescents.  However, it is not clear if it is actually superior to the other SSRIs in this regard.  Of note, this medication has a longer half life, and thus stays in the body much longer than other SSRIs.  These medications carry a special warning, of increased suicidal thinking and behavior in children, adolescents and young adults.

Mental health providers treating children and adolescents with depression have seen the benefits SSRIs have on the successful treatment of MDD. Although the proven efficacy of these medications in group studies has been inconsistent, and there is concern regarding their safety, the number of individual patients and families that have been positively affected by the careful and prudent use of SSRIs cannot be understated.

Sources

Stanford Medicine Resources:

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