Dr. Komaroff
Dr. Komaroff

Dear Dr. K: I have been taking an SSRI for years for chronic anxiety. Are there side effects of long-term SSRI use?


What are SSRIs? The full name is selective serotonin reuptake inhibitors (SSRIs). They were created to treat depression, but they have been a first choice treatment for anxiety disorders since the 1990s. Popular SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil) and sertraline (Zoloft).


Between one nerve cell and another there is a small space. One cell releases a neurotransmitter into that space. The neurotransmitter travels like a boat across a pond and locks onto a structure on the other cell. The structure is called a receptor. When serotonin released by one cell travels to another cell and locks onto its receptor, one cell has "talked" to another.

SSRIs cause more serotonin signals to travel from one brain cell to another. As a result, SSRIs amplify effects of serotonin on mood and anxiety. SSRIs may indirectly influence other neurotransmitters that play a role in anxiety. These include norepinephrine and dopamine.

SSRIs are generally safe drugs. A big reason they're popular — with doctors and patients — is that they have fewer and less severe side effects than older anxiety medications.






