Selective Serotonin Reuptake Inhibitors

These medications are the first line for treatment of depression in the modern healthcare environment, on account of relative safety and acceptable efficacy. There is an argument that the older medications, the tricyclic antidepressants and MAOIs, are more effective, but on the one hand this assertion is not adequately proven and on the other the SSRIs are safer. However, there is a recent issue of whether the SSRIs could increase suicidal ideation in the first few weeks on them, and this issue should be taken seriously. There is no clear evidence showing an increase in completed suicides, that is to say deaths. This should be taken to indicate that if there is no clinical depression or other indicated significant clinical syndrome present they should not be prescribed. They remain a very useful class of medication, particularly in the neuropsychiatric setting given their freedom from anticholinergic effects (which impair cognition) and sedation. Further information about the current risks of antidepressants are on the Medsafe website.