SSRIs

Question 1

Fluoxetine/Prozac

Answer 1

Pros: A LOT OF INDICATIONS
MDD
OCD
PMDD
Bulimia nervosa (FIRST LINE)
Panic disorder
off-label social anxiety
off-label PTSD
Low on weight gain

Cons:
Not good for anorexia nervosa
Can be activating /stimulating for anxiety, in long term
Temporarily increased anxiety
Can cause hyponatremia, especially in older adults

Question 2

Sertraline/Zoloft

Answer 2

Pros
A lot of indications: Anxiety, depression, PTSD, OCD, panic attacks, PMDD, social anxiety
Increases energy level
The one SSRI that generally does not elevate prolactin
Highest cardiovascular safety out of all SSRIs

Cons
Contraindicated in IBS
Can increase anxiety or insomnia initially
Higher risk of weight gain than prozac

Question 3

Escitalopram/Lexapro

Answer 3

Wakes people up
Fast onset of action
Good for panic attacks
Good for PTSD
Works on both insomnia and hypersomnia
Good for anxiety
Low on weight gain (lower risk of weight gain than prozac)
Interacts with fewer meds than Celexa

ADRs
Sexual ADRs
GI ADRs (nausea, diarrhea, dry mouth, constipation)
CNS ADRs (agitation, tremors, headache, dizziness, insomnia, sedation
Can prolong QT interval when given with other meds that have that same ADR

Question 4

Paroxetine/Paxil

Answer 4

Pros
Anxiety
OCD
PTSD
Insomnia
Panic attacks
Mildly anticholinergic (makes it sedating but also adds the anticholinergic ADRs)

Cons
Worse withdrawal than other SSRIs
May have greater weight gain and sexual ADRs than other SSRIs

Question 5

Citalopram/celexa

Answer 5

Pros
Not excessively activating or sedating
Safe for elderly
Can be sedating in some (can help insomnia)
Works for hypersomnia
Good for depression, anxiety, panic attacks

Cons
Need dose titration for efficacy