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(Selective serotonin reuptake inhibitors) What are they? • Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants prescribed for depression and anxiety disorders. They work by increasing the amount of the neurotransmitter serotonin. First developed in the 1970s, allegedly with fewer side effects than their predecessors, they continue to generate controversy. Like most antidepressants, the SSRIs are most effective when used in combination with cognitive behavioral therapy and other forms of therapy. How do they work? • Serotonin is a neurotransmitter (a messenger chemical that carries signals between nerve cells in the brain). It's thought to have a good influence on mood, emotion and sleep. • After carrying a message, serotonin is usually reabsorbed by the nerve cells (known as "reuptake"). SSRIs work by blocking ("inhibiting") reuptake, meaning more serotonin is available to pass further messages between nearby nerve cells. Evaluation of SSRI’s • An advantages of SSRI’s are that they are easily available, and are a quicker way of treating depression compared to therapy which can be a longer process. • This explanation of SSRI’s is appealing because of its simplicity; however, as is so often true of explanations about drugs that affect the brain, this explanation is probably inadequate. • One problem is that no one is quite sure what causes depression. Everyone knows, or will likely know one day, what it feels like to be depressed. This is why depression is often referred to as "the common cold of mental illness." • As their name suggests, SSRIs enhance the actions of serotonin by preventing its inactivation by reuptake. One nagging problem has been that SSRIs block reuptake of serotonin as soon as they enter the brain, yet the depression is not resolved for many weeks. This does not make sense. Why shouldn't we feel better immediately? Evaluation of SSRI’s • A study in the Journal of the American Medical Association says that SSRI's like Paxil and Prozac are no more effective in treating depression than a placebo pill. • A January 4 article in MedPage Today cites a study done at Columbia University and Johns Hopkins. The study says that doctors routinely prescribe not one but two or three SSRI's and other psychopharmological drugs in combination with few if any serious studies to back up the multiple usage. It's pretty obvious that the reason for these multiple prescriptions is that if one drug doesn't work, then perhaps two or three will. • Drugs can become addictive, and if you have been taking them for a long time you can start to become resistant, meaning a higher dosage is needed. Activity • Watch the following video and answer the questions on the next slide • https://www.youtube.com/watch?v=3c-KTc923Bc • 1.18 Questions • What are 2 psychological activities are serotonin are involved in? • What is 5-HT also known as? • What are the two neurons called? • What is the difference in serotonin levels between people who have depression and people who do not? • What do SSRI’s do?