|
Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants used in the treatment of depression, anxiety disorders, and some personality disorders. They are also typically effective and used in treating premature ejaculation problems. SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitors. ...
Image File history File links Serotonin_(5-HT). ...
Image File history File links Serotonin_(5-HT). ...
Serotonin (pronounced ) (5-hydroxytryptamine, or 5-HT) is a monoamine neurotransmitter synthesized in serotonergic neurons in the central nervous system (CNS) and enterochromaffin cells in the gastrointestinal tract of animals including humans. ...
Prozac, a selective serotonin reuptake inhibitor (SSRI) Serotonin-norepinephrine reuptake inhibitor, Venlafaxine An antidepressant, is a psychiatric medication or other substance (nutrient or herb) used for alleviating depression or dysthymia (milder depression). ...
On the Threshold of Eternity. ...
Anxiety disorder is a blanket term covering several different forms of abnormal, pathological anxiety, fears, phobias. ...
Personality disorder, formerly referred to as a Characterological disorder is a class of mental disorders characterized by rigid and on-going patterns of thought and action. ...
Premature ejaculation (PE), also known as rapid ejaculation, premature climax or early ejaculation, is the most common sexual problem in men, affecting 25%-40% of men. ...
SSRIs increase the extracellular level of the neurotransmitter serotonin by inhibiting its reuptake into the presynaptic cell, increasing the level of serotonin available to bind to the postsynaptic receptor. They have varying degrees of selectivity for the other monoamine transporters, having little binding affinity for the noradrenaline and dopamine transporters. In cell biology, molecular biology and related fields, the word extracellular means outside the cell. It is used in contrast to intracellular (inside the cell). ...
Chemical structure of D-aspartic acid, a common amino acid neurotransmitter. ...
Serotonin (pronounced ) (5-hydroxytryptamine, or 5-HT) is a monoamine neurotransmitter synthesized in serotonergic neurons in the central nervous system (CNS) and enterochromaffin cells in the gastrointestinal tract of animals including humans. ...
Reuptake, or re-uptake, is the reabsorption of a neurotransmitter by the neurotransmitter transporter of a pre-synaptic neuron after it has performed its function of transmitting a neural impulse. ...
Prasynaptic cells send signals to postsynaptic cells via a synaptic cleft by neurotransmitters. ...
Serotonin (pronounced ) (5-hydroxytryptamine, or 5-HT) is a monoamine neurotransmitter synthesized in serotonergic neurons in the central nervous system (CNS) and enterochromaffin cells in the gastrointestinal tract of animals including humans. ...
Monoamine transporters, as the name implies, transfer monoamine neurotransmitters in or out of a cell. ...
Norepinephrine, known as noradrenaline outside the USA, is a catecholamine and a phenethylamine with chemical formula C8H11NO3. ...
For other uses, see Dopamine (disambiguation). ...
The first class of psychotropic drugs to be rationally designed, SSRIs are the most widely prescribed antidepressants in many countries.[1] A psychoactive drug or psychotropic substance is a chemical that alters brain function, resulting in temporary changes in perception, mood, consciousness, or behavior. ...
Drug design is the approach of finding drugs by design, based on their biological targets. ...
List of SSRIs Drugs in this class include:
(Trade names in parentheses) - citalopram (Celexa, Cipramil, Emocal, Sepram, Seropram)
- escitalopram oxalate (Lexapro, Cipralex, Esertia)
- fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem, Fluctin (EUR))
- fluvoxamine maleate (Luvox, Faverin)
- paroxetine (Paxil, Seroxat, Aropax, Deroxat, Rexetin, Xetanor, Paroxat)
- sertraline (Zoloft, Lustral, Serlain)
- dapoxetine (no known trade name)
Citalopram is an antidepressant drug used to treat depression associated with mood disorders. ...
Escitalopram oxalate (also known as LexaproTM and CipralexTM) is a medication developed by the Danish pharmaceutical company Lundbeck, that acts as a selective serotonin reuptake inhibitor or SSRI. It is typically used as an antidepressant to treat depression associated with mood disorders although also may be used in the treatment...
Prozac redirects here. ...
Fluvoxamine maleate (sold under the brand-names Luvox® and Faverin®) is a selective serotonin reuptake inhibitor. ...
Paroxetine (Paxil, Seroxat, Pexeva) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. ...
Zoloft bottles, with blue and green tablets Sertraline hydrochloride (also sold under brand names Zoloft, Lustral, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton, Xydep, Serlain, Concorz) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ...
Dapoxetine is the International Nonproprietary Name of a drug currently being considered for approval by the FDA for the treatment of premature ejaculation in men, which would make it the first drug approved for such treatment. ...
Related antidepressants SSRIs form a subclass of Serotonin uptake inhibitors, which includes other non-selective inhibitors as well. Serotonin-norepinephrine reuptake inhibitor, Serotonin-noradrenaline-dopamine reuptake inhibitors and Selective serotonin reuptake enhancers are also serotonergic antidepressants. A serotonin uptake inhibitor is a drug which acts as a neurotransmitter uptake inhibitor on serotonin receptors. ...
Myoglobin (blue) with its ligand heme (orange) bound. ...
Serotonin Norepinephrine Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant used in the treatment of clinical depression and other affective disorders. ...
Serotonin-norepinephrine-dopamine-reuptake-inhibitors (SNDRI) are a class of psychoactive antidepressants. ...
Tianeptine (INN) (Stablon®, Coaxil®, Tatinol®), is structurally similar to the tricyclic antidepressants. ...
Serotonergic means related to, capable of producing, altering, or releasing serotonin, a neurotransmitter, and can refer to the following classes of chemicals: Selective serotonin reuptake inhibitor - A common class of serotonergic antidepressants Noradrenergic and specific serotonergic antidepressant - Another class of serotonergic antidepressants serotonergic psychedelics - The serotonergic hallucinogenic drugs This is...
Medical indications The main indication for SSRIs is clinical depression. Apart from this, SSRIs are frequently prescribed for anxiety disorders like social anxiety, panic disorders, obsessive-compulsive disorder (OCD), eating disorders, and chronic pain. Though not specifically indicated by the manufacturers, they are also sometimes prescribed to treat irritable bowel syndrome (IBS) and Lichen simplex chronicus. Additionally, SSRIs have been found to be effective in treating both pathological laughter and crying (PLC) and premature ejaculation in up to 60% of men. All SSRIs are approved in conjunction with psychiatric disorders as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV). On the Threshold of Eternity. ...
Anxiety disorder is a blanket term covering several different forms of abnormal, pathological anxiety, fears, phobias. ...
Social anxiety is an experience of fear, apprehension or worry regarding social situations and being evaluated by others. ...
Panic Disorder is a psychiatric condition characterized by recurring panic attacks in combination with significant behavioral change or at least a month of ongoing worry about the implications or concern about having other attacks. ...
Chronic pain was originally defined as pain that has lasted 6 months or longer. ...
Lichen simplex chronicus is a skin disorder characterized by chronic itching and scratching. ...
Premature ejaculation (PE), also known as rapid ejaculation, premature climax or early ejaculation, is the most common sexual problem in men, affecting 25%-40% of men. ...
Psychiatry is a branch of medicine that studies and treats mental and emotional disorders (see mental illness). ...
The Diagnostic and Statistical Manual published by the American Psychiatric Association The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a handbook for mental health professionals that lists different categories of mental disorder and the criteria for diagnosing them, according to the publishing organization the American Psychiatric Association. ...
Different SSRIs have different approval uses in different countries dependent on the overseeing medical branch of government in charge of regulating drugs. In the United States, the Food and Drug Administration (FDA) makes these approvals after trials have been submitted by pharmaceutical companies. In Europe a single body, The European Medicines Agency approves medicines for human consumption throughout the EU. “FDA†redirects here. ...
A pharmaceutical company, or drug company, is a commercial business whose focus is to research, develop, market and/or distribute drugs, most commonly in the context of healthcare. ...
The European Medicines Agency (EMEA) is a European agency for the evaluation of medicinal products. ...
Contraindications / drug interaction SSRIs are contraindicated with concomitant use of MAOIs (monoamine oxidase inhibitors). This can lead to increased serotonin levels which could cause a serotonin syndrome. People taking SSRIs should also avoid taking pimozide (an antipsychotic diphenylbutylpiperidine derivative). The atypical opioid analgesic tramadol hydrochloride (or Ultram, Ultracet) can, in rare cases, produce seizures when taken in conjunction with an SSRI or tricyclic antidepressant. Hepatic impairment is another contraindication for medications of this type. MAOI redirects here. ...
Serotonin syndrome is a rare, but potentially life-threatening adverse drug reaction that results from intentional self-poisoning, therapeutic drug use, or inadvertent interactions between drugs. ...
Pimozide (sold as Orap®) is an antipsychotic drug. ...
The term antipsychotic is applied to a group of drugs used to treat psychosis. ...
An opioid is a chemical substance that has a morphine-like action in the body. ...
Tramadol (INN) (IPA: ) is an atypical opioid which is a centrally acting analgesic, used for treating moderate to severe pain. ...
Chemical structure of the tricyclic antidepressant amitriptyline. ...
Mode of action SSRIs acts by inhibiting the reuptake of serotonin after being released in synapses. How much an individual will respond to this, however, also depends on genetics. In addition, several other mechanisms are suggested for the desired effect, e.g. neuroprotection and anti-inflammatory and immunomodulatory factors. Taken together, SSRI has several advantages compared with tricyclic antidepressants (TCA)s and 5-HT-prodrugs. However, the latter might be required in addition to SSRIs in certain situations. Serotonin (pronounced ) (5-hydroxytryptamine, or 5-HT) is a monoamine neurotransmitter synthesized in serotonergic neurons in the central nervous system (CNS) and enterochromaffin cells in the gastrointestinal tract of animals including humans. ...
Chemical structure of the tricyclic antidepressant amitriptyline Tricyclic antidepressants are a class of antidepressant drugs first used in the 1950s. ...
A prodrug is a pharmacological substance (drug) which is administered in an inactive (or significantly less active) form. ...
Basic understanding - Further information: Chemical synapse
In the brain, messages are passed between two nerve cells via a synapse, a small gap between the cells. The cell that sends the information releases neurotransmitters (of which serotonin is one) into that gap. The neurotransmitters are then recognized by receptors on the surface of the recipient (postsynaptic) cell, which upon this stimulation, in turn, relays the signal. About 10% of the neurotransmitters are lost in this process, the other 90% are released from the receptors and taken up again by monoamine transporters into the sending (presynaptic) cell (a process called reuptake). Illustration of the major elements in a prototypical synapse. ...
The human brain In animals, the brain (enkephalos) (Greek for in the skull), is the control center of the central nervous system, responsible for behavior. ...
This article is about cells in the nervous system. ...
Illustration of the major elements in a prototypical synapse. ...
Chemical structure of D-aspartic acid, a common amino acid neurotransmitter. ...
In biochemistry, a receptor is a protein on the cell membrane or within the cytoplasm or cell nucleus that binds to a specific molecule (a ligand), such as a neurotransmitter, hormone, or other substance, and initiates the cellular response to the ligand. ...
Monoamine transporters, as the name implies, transfer monoamine neurotransmitters in or out of a cell. ...
Some theories link depression to a lack of stimulation of the recipient neuron at a synapse [citation needed]. To stimulate the recipient cell, SSRIs inhibit the reuptake of serotonin. As a result, the serotonin stays in the synaptic gap longer than it normally would, and may be recognized again (and again) by the receptors of the recipient cell, stimulating it. On the Threshold of Eternity. ...
Pharmacodynamics SSRIs inhibit the reuptake of the neurotransmitter serotonin (5-hydroxytryptamine or 5-HT) into the presynaptic cell, increasing levels of 5-HT within the synaptic cleft. Serotonin (pronounced ) (5-hydroxytryptamine, or 5-HT) is a monoamine neurotransmitter synthesized in serotonergic neurons in the central nervous system (CNS) and enterochromaffin cells in the gastrointestinal tract of animals including humans. ...
Synapses allow nerve cells to communicate with one another through axons and dendrites, converting electrical signals into chemical ones. ...
But there is one counteracting effect: high serotonin levels will not only activate the postsynaptic receptors, but also flood presynaptic autoreceptors, that serve as a feedback sensor for the cell. Activation of the autoreceptors (by agonists like serotonin) triggers a throttling of serotonin production. The resulting serotonin deficiency persists for some time, as the transporter inhibition occurs downstream to the cause of the deficiency, and is therefore not able to counterbalance it. The body adapts gradually to this situation by lowering (downregulating) the sensitivity of the autoreceptors. A synapse is a connection between two neurons: presynaptic and postsynaptic. ...
This article needs to be cleaned up to conform to a higher standard of quality. ...
Agonists An agonist is a substance that binds to a receptor and triggers a response in the cell. ...
Down regulation is the process by which a cell decreases the number of receptors to a given hormone or neurotransmitter to reduce its sensitivity to this molecule. ...
Of greater importance is another adaptive process: the downregulation of postsynaptic serotonin 5-HT2A receptors. After the use of a SSRI, since there is more serotonin available, the response is to lower (to normal levels or less) the number of postsynaptic receptors over time, and in the long run, this modifies the serotonin/receptor ratio. Since a larger percentage of available receptors become activated by serotonin, transmission is enhanced or restored. The introduction to this article provides insufficient context for those unfamiliar with the subject matter. ...
These (slowly proceeding) neurophysiological adaptions of the brain tissue are the reason why usually several weeks of continuous SSRI use are necessary for the antidepressant effect to become fully manifested, and why increased anxiety is a common side effect in the first few days or weeks of use.
Pharmacogenetics - Further information: Pharmacogenetics
Large bodies of research are devoted to using genetic markers to predict whether patients will respond to SSRI's or have side effects which will cause their discontinuation, although these tests are not yet ready for widespread clinical use. [2] Single nucleotide polymorphisms of the 5-HT(2A) gene correlates with increased paroxetine discontinuation, but not mirtazapine (a non-SSRI antidepressant) discontinuation [3] The terms pharmacogenomics and pharmacogenetics tend to be used interchangeably, and a precise, consensus definition of either remains elusive. ...
A genetic marker is a known DNA sequences (e. ...
Look up discontinuation in Wiktionary, the free dictionary. ...
A Single Nucleotide Polymorphism or SNP (pronounced snip) is a DNA sequence variation, occurring when a single nucleotide: adenine (A), thymine (T), cytosine (C) or guanine (G) - in the genome is altered. ...
Serotonin (5_hydroxytryptamine, or 5_HT) is a monoamine neurotransmitter synthesised in serotonergic neurons in the central nervous system and enterochromaffin cells in the gastrointestinal tract. ...
Paroxetine (Paxil, Seroxat, Pexeva) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. ...
Mirtazapine is an antidepressant introduced by Organon International in 1996 used for the treatment of mild to severe depression. ...
Neuroprotection Studies have suggested that SSRIs may promote the growth of new neural pathways or neurogenesis in rats.[4] Also, SSRIs may protect against neurotoxicity caused by other compounds (for instance MDMA and Fenfluramine) as well as from depression itself. A neural pathway is a neural tract connecting one part of the nervous system with another, usually consisting of bundles of elongated, myelin insultated neurons, known collectively as white matter. ...
Neurogenesis (birth of neurons) is the process by which neurons are created. ...
ecstasy and religious ecstasy MDMA, most commonly known today by the street name ecstasy, is a synthetic entactogen of the phenethylamine family whose primary effect is to stimulate the brain to rapidly secrete large amounts of serotonin, causing a general sense of openness, empathy, energy, euphoria, and well-being. ...
Fenfluramine is a drug that was part of the Fen-Phen anti-obesity medication (the other drug being phentermine). ...
Anti-inflammatory and Immunomodulation Recent studies show pro-inflammatory cytokine processes take place during depression, mania and bipolar disease, in addition to somatic disease (such as autoimmune hypersensitivity) and is possible that symptoms manifest in these psychiatric illnesses are being attenuated by pharmacological affect of antidepressants on the immune system.[5][6][7][8][9] Cytokines are a group of proteins and peptides that are used in organisms as signaling compounds. ...
On the Threshold of Eternity. ...
This article is an expansion of a section entitled Mania from within the main article Bipolar disorder. ...
For other uses, see Bipolar. ...
The term somatic refers to the body, as distinct from some other entity, such as the mind. ...
Hypersensitivity refers to undesirable (damaging, discomfort-producing and sometimes fatal) reactions produced by the normal immune system. ...
SSRI's have been shown to be immunomodulatory and anti-inflammatory against pro-inflammatory cytokine processes, specifically on the regulation of Interferon-gamma (IFN-gamma) and Interleukin-10 (IL-10), as well as TNF-alpha and Interleukin-6 (IL-6). Antidepressants have also been shown to suppress TH1 upregulation.[10][11][12][13] SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ...
Cytokines are a group of proteins and peptides that are used in organisms as signaling compounds. ...
Interferon-gamma or IFN-g is a dimerized soluble cytokine which is a Type II Interferon. ...
Interleukin-10 (IL-10 or IL10), also known as human cytokine synthesis inhibitory factor (CSIF), is an anti-inflammatory cytokine, capable of inhibiting synthesis of pro-inflammatory cytokines like IFN-gamma, IL-2, IL-3, TNFα and GM-CSF by cells such as macrophages and Th1 cells. ...
In medicine, tumor necrosis factor alpha (TNFα, cachexin or cachectin) is an important cytokine involved in systemic inflammation and the acute phase response. ...
Interleukin-6 (IL-6) is a pro-inflammatory cytokine secreted by T cells and macrophages to stimulate immune response to trauma, especially burns or other tissue damage leading to inflammation. ...
Antigen presentation stimulates T cells to become either cytotoxic CD8+ cells or helper CD4+ cells. ...
Future serotonergic antidepressants may be made to specifically target the immune system by either blocking the actions of pro-inflammatory cytokines or increasing the production of anti-inflammatory cytokines.[14]
SSRIs versus TCAs SSRIs are described as 'selective' because they affect only the reuptake pumps responsible for serotonin, as opposed to earlier antidepressants, which affect other monoamine neurotransmitters as well. Because of this, SSRIs lack some of the side effects of the more general drugs. Myoglobin (blue) with its ligand heme (orange) bound. ...
There appears to be no significant difference in effectiveness between SSRIs and tricyclic antidepressants, which were the most commonly used class of antidepressants before the development of SSRIs.[15] However, SSRIs have the important advantage that their toxic dose is high, and, therefore, they are much more difficult to use as a means to commit suicide. Further, they have fewer and milder side effects. Tricyclic antidepressant also have a higher risk of serious cardiovascular side effects which SSRIs lack. Chemical structure of the tricyclic antidepressant amitriptyline. ...
The term drug overdose (or simply overdose) describes the ingestion or application of a drug or other substance in quantities greater than are recommended or generally practiced. ...
For other uses, see Suicide (disambiguation). ...
An adverse drug reaction (abbreviated ADR) is a term to describe the unwanted, negative consequences sometimes associated with the use of medications. ...
SSRIs versus 5-HT-Prodrugs - Further information: Prodrugs
Serotonin cannot be administered directly because when ingested orally, it will not cross the blood-brain barrier, and therefore would have no effect on brain functions. Also, serotonin would activate every synapse it reaches, whereas SSRIs only enhance a signal that is already present, but too weak to come through. A prodrug is a pharmacological substance (drug) which is administered in an inactive (or significantly less active) form. ...
The blood-brain barrier (BBB) is a membranic structure that acts primarily to protect the brain from chemicals in the blood, while still allowing essential metabolic function. ...
SSRIs together with 5-HT-Prodrugs Biosynthetically serotonin is made from tryptophan, an amino acid. If depression is caused by lack of serotonin, rather than insensitivity to it, SSRIs alone will not work well, whereas supplementing with tryptophan will. In 1989, the Food and Drug Administration made tryptophan available by prescription only, in response to an outbreak of eosinophilia-myalgia syndrome caused by impure L-tryptophan supplements sold over-the-counter. With current standards, L-tryptophan is again available over the counter in the US as well as supplement 5-HTP which is a direct precursor to serotonin. Combining 5-HTP with SSRIs may lead to serotonin syndrome, as a result of too much serotonin activity in the brain. A doctor should be consulted before combining the two. Biosynthesis is a phenomenon where chemical compounds are produced from simpler reagents. ...
Tryptophan (abbreviated as Trp or W)[1] is one of the 20 standard amino acids, which are the building blocks of proteins, and an essential amino acid in the human diet. ...
This article is about the class of chemicals. ...
“FDA†redirects here. ...
A medical prescription ) is an order (often in written form) by a qualified health care professional to a pharmacist or other therapist for a treatment to be provided to their patient. ...
Eosinophilia-myalgia syndrome is an incurable and sometimes fatal flu-like neurological condition that was caused by contaminated L-tryptophan supplements. ...
Over-the-counter (OTC) drugs are medicines that may be sold without a prescription, in contrast to prescription drugs. ...
5-HTP (5-Hydroxy-tryptophan) is decarboxylated to the neurotransmitter serotonin (5-HT) by the enzyme aromatic-L-amino-acid decarboxylase. ...
Serotonin syndrome is a rare, but potentially life-threatening adverse drug reaction that results from intentional self-poisoning, therapeutic drug use, or inadvertent interactions between drugs. ...
Adverse effects
General side effects General side effects are mostly present during the first 1-4 weeks while the body adapts to the drug (with the exception of sexual side effects, which tend to occur later in treatment). In fact, it often takes 6-8 weeks for the drug to begin reaching its full potential (the slow onset is considered a downside to treatment with SSRIs). Almost all SSRIs are known to cause one or more of these symptoms: Common gastrointestinal side effects include nausea, vomiting, and diarrhea, which are brought about by the actions of serotonin on the gastrointestinal tract. Somnolence (or drowsiness) is a state of near-sleep, a strong desire for sleep, or sleeping for unusually long periods. ...
Internal and external views of an arm with a compound fracture, both before and after surgery A bone fracture is a medical condition in which a bone breaks. ...
This article is about sexual practices (i. ...
A panic attack is a period of intense fear or discomfort, typically with an abrupt onset and usually lasting no more than 30 minutes. ...
Anatomy and Physiology of the A.N.S. In contrast to the voluntary nervous system, the involuntary or autonomic nervous system is responsible for homeostasis, maintaining a relatively constant internal environment by controlling such involuntary functions as digestion, respiration, and metabolism, and by modulating energy needed to cope with stressful...
Orthostatic hypotension (also known as postural hypotension, orthostatic intolerance and, colloquially, as head rush or a dizzy spell) is a sudden fall in blood pressure, typically greater than 20/10 mm Hg, that occurs when a person assumes a standing position, usually after a prolonged period of rest. ...
Perspiration (also called sweating or sometimes transpiration) is the production and evaporation of a fluid, consisting primarily of water as well as a smaller amount of sodium chloride (the main constituent of table salt), that is excreted by the sweat glands in the skin of mammals. ...
Akathisia (or acathisia) is an often extremely unpleasant subjective sensation of inner restlessness that manifests itself with an inability to sit still or remain motionless, hence the origin of its name: Greek a (without) + kathesis (sitting). ...
Renal failure is the condition in which the kidneys fail to function properly. ...
Suicidal ideation is common medical term for the mere thoughts about and of plans of committing suicide, not the actual following through or act itself. ...
For other uses, see Suicide (disambiguation). ...
For other uses, see Nausea (disambiguation). ...
Emesis redirects here. ...
Diarrhea, also spelled diarrhoea (see spelling differences), is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάÏÏοια; literally meaning through-flowing). Acute infectious diarrhea is a common cause of death in developing countries (particularly among infants), accounting for 5 to 8 million deaths...
Gut redirects here. ...
Most side effects usually disappear after the adaptation phase, when the antidepressive effects begin to show. However, despite being called general, the side effects and their durations are highly individual and drug-specific. Usually the treatment is begun with a small dose to see how the patient's body reacts to the drug, after that either the dose can be adjusted (eg. Prozac in the UK is begun at a 20mg dose, and then adjusted as necessary to 40mg or 60mg). Should the drug prove not to be effective, or the side effects intolerable to the patient, another common route is to switch treatment to either another SSRI, or an SNRI.[16] Serotonin Norepinephrine Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant used in the treatment of clinical depression and other affective disorders. ...
Mania or hypomania is a possible side-effect. Users with some type of bipolar disorder are at a much higher risk, however SSRI-induced mania in patients previously diagnosed with unipolar depression can trigger a bipolar diagnosis. This article is an expansion of a section entitled Mania from within the main article Bipolar disorder. ...
Hypomania is a mood state characterized by persistent and pervasive elated or irritable mood, and thoughts and behaviors that are consistent with such a mood state. ...
For other uses, see Bipolar. ...
Sexual side effects - See also: Post SSRI Sexual Dysfunction
SSRIs can cause various types of sexual dysfunction such as anorgasmia, erectile dysfunction, and diminished libido. Initial studies found that such side effects occur in less than 10% of patients, but since these studies relied on unprompted reporting, the frequency was probably underestimated. In more recent studies, doctors have specifically asked about sexual difficulties, and found that they are present in between 17% [17] and 41% [18] of patients. This dysfunction occasionally disappears spontaneously without stopping the SSRI, and in most cases resolves after discontinuation. In some cases, however, it does not; this is known as Post SSRI Sexual Dysfunction (PSSD). Post SSRI Sexual Dysfunction (PSSD) is a type of sexual dysfunction caused by the previous use of SSRI antidepressants. ...
Sexual dysfunction or sexual malfunction (see also sexual function) is difficulty during any stage of the sexual act (which includes desire, arousal, orgasm, and resolution) that prevents the individual or couple from enjoying sexual activity. ...
Anorgasmia (also known as Retarded Ejaculation in males) is a form of sexual dysfunction, sometimes classified as a psychiatric disorder, where the patient cannot achieve orgasm, even with adequate stimulation. ...
Erectile dysfunction (ED) or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis. ...
For other uses, see Libido (disambiguation). ...
Post SSRI Sexual Dysfunction (PSSD) is a type of sexual dysfunction caused by the previous use of SSRI antidepressants. ...
It is believed that sexual dysfunction is caused by an SSRI induced reduction in dopamine. Stimulation of postsynaptic 5-ht2 and 5-ht3 receptors decreases dopamine release from the Substantia Nigra. Sexual dysfunction caused by SSRIs can sometimes be mitigated by several different drugs. These include: For other uses, see Dopamine (disambiguation). ...
The substantia nigra, (Latin for black substance, Soemering) or locus niger is a heterogeneous portion of the midbrain, separating the pes (foot) from the tegmentum (covering), and a major element of the basal ganglia system. ...
On the other hand, the effect of SSRIs to slow down sexual stimulation may be used as treatment; SSRIs have been proposed as a drug to treat premature ejaculation.[19] Bupropion (INN; also amfebutamone,[1] brand names Wellbutrin, Zyban, Budeprion and Buproban) is an atypical antidepressant, which acts as a norepinephrine reuptake inhibitor and dopamine reuptake inhibitor,[2] and a nicotinic antagonist. ...
Norepinephrine reuptake inhibitors (NRIs) are compounds that increase amounts of the neurotransmitter norepinephrine in the brain by inhibiting its reuptake at synapses. ...
This does not cite any references or sources. ...
Buspirone (brand-names Ansial, Ansiced, Anxiron, Axoren, Bespar, BuSpar, Buspimen, Buspinol, Buspisal, Narol, Spitomin, Sorbon) is an anxiolytic agent and a serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. ...
A serotonin receptor agonist is a compound that activates serotonin receptors, mimicking the effect of the neurotransmitter serotonin. ...
Vitamin R redirects here. ...
Mirtazapine is an antidepressant introduced by Organon International in 1996 used for the treatment of mild to severe depression. ...
Noradrenergic and specific serotonergic antidepressants (abbreviated: NaSSAs) are a relatively new class of antidepressants. ...
Amphetamine or Amfetamine(Alpha-Methyl-PHenEThylAMINE), also known as beta-phenyl-isopropylamine and benzedrine, is a prescription stimulant commonly used to treat Attention-deficit hyperactivity disorder (ADHD) in adults and children. ...
Amantadine, 1-aminoadamantane, is an antiviral drug that was approved by the FDA in 1976 for the treatment of influenza type A in adults. ...
Antiviral drugs are a class of medication used specifically for treating viral infections. ...
Pramipexole (INN, trade names Mirapex® and Sifrol®) is a medication indicated for treating Parkinsons disease and restless legs syndrome (RLS). ...
Dopamine agonist is a synthetic drug that mimics the effect of the neurotransmitter dopamine. ...
Requip (ropinirole) is so far the only medication in the United States with an FDA approved indication for the treatment of Restless Legs Syndrome. ...
Dopamine agonist is a synthetic drug that mimics the effect of the neurotransmitter dopamine. ...
Premature ejaculation (PE), also known as rapid ejaculation, premature climax or early ejaculation, is the most common sexual problem in men, affecting 25%-40% of men. ...
Cardiovascular side effects Cardiovascular side effects are very rare with SSRI use, with a reported incidence of less than 0.0003 percent.[20] SSRIs inhibit cardiac and vascular sodium, calcium and potassium channels and prolong QT intervals.[21] However, a number of large studies of patients without known pre-existing heart disease have reported no EKG changes related to SSRI use.[22] In overdose, fluoxetine has been reported to cause sinus tachycardia, myocardial infarction, junctional rhythms and trigeminy. Some authors have suggested electrocardiographic monitoring in patients with severe pre-existing cardiovascular disease who are taking SSRI's.[23] Incidence is a measure of the risk of developing some new condition within a specified period of time. ...
Sodium channels are integral membrane proteins that exist in a cells plasma membrane and regulate the flow of sodium (Na+) ions into it. ...
Ion channels are present in the membranes that surround all biological cells. ...
In cell biology, potassium channels are the most common type of ion channel. ...
Schematic representation of normal ECG trace (sinus rhythm), with waves, segments, and intervals labeled. ...
“QRS†redirects here. ...
Sinus tachycardia is a rhythm with elevated rate of impulses originating from the SA node, defined as a rate greater than 100 beats/min in an average adult. ...
Heart attack redirects here. ...
This article or section cites very few or no references or sources. ...
Cardiac arrhythmia is any of a group of conditions in which the electrical activity of the heart is irregular or is faster or slower than normal. ...
“QRS†redirects here. ...
Discontinuation syndrome -
SSRIs are not addictive in the conventional medical use of the word (i.e. animals given free access to the drug do not actively seek it out and do not seek to increase the dose), but suddenly discontinuing their use is known to produce both somatic and psychological withdrawal symptoms. Notably patients describe having "Brain Zaps" or "Fever Jolts". Discontinuation symptoms can last from weeks to months and can be distressing for the patient. SSRI discontinuation syndrome, also known as SSRI withdrawal syndrome or SSRI cessation syndrome, is a condition that can occur during or following the interruption, lowering of dose or discontinuation of regular SSRI or SNRI antidepressant drug usage. ...
Withdrawal, also known as withdrawal syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes physical dependence is regularly used for a long time and then suddenly discontinued or decreased in dosage. ...
Suicidality and Aggression Over the years there have been many accusations by patients and their families of SSRIs causing suicidal ideation and aggressive (or homicidal) behavior. The scientific evidence supporting this claim has been criticized by drug advocates, but alternative medicine sites often claim that patients committed suicide or engaged in aggressive and / or criminal acts using SSRIs.[24] Manufacturers of SSRIs historically have vehemently denied any such link and have always blamed the disease rather than the treatment. However, evidence from case studies, epidemiological studies, experimental research, and theory supports the view that SSRIs increase suicide risk for some patients.[25] Suicidal ideation is common medical term for the mere thoughts about and of plans of committing suicide, not the actual following through or act itself. ...
Alternative medicine has been described as any of various systems of healing or treating disease (as chiropractic, homeopathy, or faith healing) not included in the traditional medical curricula taught in the United States and Britain.[1] Alternative medicine practices are often based in belief systems not derived from modern science. ...
In the United States there is a required box warning for suicide risk in children. In the UK, all "antidepressant" medications except Prozac have been banned for people under 18. In late 2004 the first U.S. black box warning was added which applied only to children 12 and under. Recently experts recommended expanding the warning to adults. In general the risk of suicide is twice as great when taking an SSRI regardless of the type of diagnosis or whether the patient was considered a healthy volunteer for trial purposes.
On Dec 13, 2006, a U.S. Food and Drug Administration advisory panel recommended that "black-box" warnings on SSRIs be raised from 18 to 25 years old. The FDA is not obliged to follow the recommendations of its advisory committees but usually does.
An October 2006 study promoted the idea that SSRIs may decrease youth suicide overall.[26] A more recent study [7] released in November 2006, however concluded only "The aggregate nature of these observational data precludes a direct causal interpretation of the results. More SSRI prescriptions... may reflect antidepressant efficacy".
According to these facts, antidepressant prescriptions for children increased by almost 8% in the first six months of 2004, if this is the case, it is difficult to link an increased suicide rate the same year to reduced use of antidepressants.
So despite the suggestions of a connection between the drop in SSRI prescriptions (even this fact is a matter of debate) and the spike in child and teen suicides, much more research will be needed before a conclusive link can be drawn.
In fact the only SSRI that is licensed for use in children in the UK and USA is Prozac. All other SSRIs have been banned from paediatric use as their safety and efficacy have not been proven. Even of its own paediatric trials of Seroxat, Glaxo said[8] “"The best which could have been achieved was a statement that although safety data was reassuring, efficacy had not been demonstrated."
A September 2007 study, to be published in American Journal of Psychiatry suggests newer antidepressants led to more suicides in teenagers.[27] kkdkd ...
Teenage suicide is the self-killing of a teenager. ...
Fluoxetine and Suicide The signs of violence and suicidality were there since the first SSRI antidepressant, Prozac (fluoxetine) was tested in premarketing trials.
In May 1984, Germany’s regulatory agency (G-BA) rejected Prozac as “totally unsuitable for treating depression.” In July 1985, Eli Lilly’s own data analysis—from a pool of 1,427 patients—showed high incidence of adverse drug effects and evidence of drug-induced violence in some patients.[28] In May 1985, FDA’s (then) chief safety investigator, Dr. Richard Kapit, wrote: “Unlike traditional tricyclic antidepressants fluoxetine’s profile of adverse side effects more closely resembles that of a stimulant drug than one that causes sedation.” He warned “It is fluoxetine’s particular profile of adverse side-effects which may perhaps, in the future give rise to the greatest clinical liabilities in the use of this medication to treat depression.”[29] One of the worlds largest corporations, Eli Lilly and Company (NYSE: LLY) is a global pharmaceutical company with headquarters in Indianapolis,Indiana, USA. A Fortune 500 corporation, the company had revenues of $12. ...
Dr. Kapit’s safety review described the clinical trial data from 46 trials with a total of 1,427 patients. He noted under the section, “Catastrophic and Serious Events,” 52 cases of “egregiously abnormal laboratory reports which were the reason for early termination,” and “additional adverse event reports not reported by the company [which] were revealed on microfiche.” Dr. Kapit reported: “In most cases, these adverse events involved the onset of an unreported psychotic episode.” There were 10 reports of psychotic episodes; 2 reports of completed suicides; 13 attempted suicides; 4 seizures—including a healthy volunteer; and 4 reports of movement disorders. In health care, including medicine, a clinical trial (synonyms: clinical studies, research protocols, medical research) is a process in which a medicine or other medical treatment is tested for its safety and effectiveness, often in comparison to existing treatments. ...
An adverse event is any change in health that occurs in a person after he or she enrolls in a clinical trial. ...
Psychosis is a generic psychiatric term for a mental state often described as involving a loss of contact with reality. Stedmans Medical Dictionary defines psychosis as a severe mental disorder, with or without organic damage, characterized by derangement of personality and loss of contact with reality and causing deterioration...
List of Movement disorders Akinesia (lack of movement) Athetosis (contorted torsion or twisting) Ataxia Ballismus (violent involuntary rapid and irregular movements) Hemiballismus Bradykinesia (slow movement) Chorea (rapid, involuntary movement) Sydenhams chorea Rheumatic chorea Huntingtons chorea Dystonia (sustained torsion) Dystonia muscularum Blepharospasm Writers cramp Spasmodic torticollis (twisting of...
In 1985 Dr. Kapit recommended “labeling warning [for] the physician that such signs and symptoms of depression may be exacerbated by this drug". No such warning was issued until 2004.
Sertraline and Aggression Pfizer’s data from the pediatric Zoloft (sertraline) trials shows that “aggression was the joint commonest cause for discontinuation from the two sertraline placebo-controlled trials in depressed children. In these trials, eight of 189 patients randomised to sertraline discontinued for aggression, agitation, or hyperkinesis, (otherwise known as akathisia) compared with no dropouts for these reasons in 184 patients on placebo. There were 15 discontinuations on Zoloft compared with two on placebo in any treatment induced manifestation of activation (i.e., suicidal ideation or attempts, aggression, agitation, hyperkinesis, or aggravated depression)". The published report failed to include this data in the analysis.[30] Pfizer Incorporated (NYSE: PFE) is the worlds largest research-based pharmaceutical company[1].[1] The company is based in New York City. ...
Akathisia (or acathisia) is an often extremely unpleasant subjective sensation of inner restlessness that manifests itself with an inability to sit still or remain motionless, hence the origin of its name: Greek a (without) + kathesis (sitting). ...
Hyperkinesis is a state of overactive restlesness in children. ...
Paroxetine and Aggression In the trials posted on the GlaxoSmithKline (GSK) website, the authors note, “hostile events are found to excess in both adults and children on paroxetine compared with placebo, and are found across indications, and both on therapy and during withdrawal".[31] GlaxoSmithKline plc (LSE: GSK NYSE: GSK) is a British based pharmaceutical, biological, and healthcare company. ...
The authors suggest that, perhaps the most significant evidence for drug-induced violence probably comes from healthy volunteer studies: hostile events occurred in three of 271 (1.1%) volunteers taking paroxetine, compared with zero in 138 taking placebo. By 2003, the UK Medicines and Healthcare Products Regulatory Agency (MHRA) received 121 cases of aggression on paroxetine, and by January 2006 that number had risen to 211.[32] Note, that estimates for such physician adverse drug effect reporting systems range between 1% and 10% of actual adverse effects on treatment.
SSRIs and Pregnancy The FDA issued a warning on July 19, 2006 stating nursing mothers on SSRIs must discuss treatment with their physicians. The United States Food and Drug Administration is the government agency responsible for regulating food, dietary supplements, drugs, cosmetics, medical devices, biologics and blood products in the United States. ...
When taken by pregnant women, selective serotonin reuptake inhibitors (SSRIs) cross the placenta and have the potential to affect newborns. Sertraline and paroxetine have been associated with congenital malformations. Some evidence suggests that SSRIs are associated with neonatal complications such as neonatal abstinence syndrome (NAS) and persistent pulmonary hypertension (PPHN). This article is about human pregnancy in biological females. ...
Zoloft bottles, with blue and green tablets Sertraline hydrochloride (also sold under brand names Zoloft, Lustral, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton, Xydep, Serlain, Concorz) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ...
Paroxetine (Paxil, Seroxat, Pexeva) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. ...
A congenital disorder is any medical condition that is present at birth. ...
Withdrawal, also known as withdrawal/abstinence syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes physical dependence is regularly used for a long time and then suddenly discontinued or decreased in dosage. ...
In medicine, pulmonary hypertension (PH) is an increase in blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting, and other symptoms, all of which are exacerbated by exertion. ...
Neonatal abstinence syndrome Neonatal abstinence syndrome is a withdrawal syndrome newborn babies. It has been documented in SSRI treatment. By November 2003, a total of 93 cases of SSRI use associated with either neonatal convulsions or withdrawal syndrome had been reported. Subsequently, the authors of a Lancet study concluded that doctors should avoid or cautiously manage the prescribing of these drugs to pregnant women with psychiatric disorders.[33] Withdrawal, also known as withdrawal/abstinence syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes physical dependence is regularly used for a long time and then suddenly discontinued or decreased in dosage. ...
Withdrawal, also known as withdrawal syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes physical dependence is regularly used for a long time and then suddenly discontinued or decreased in dosage. ...
“Baby†redirects here. ...
The Lancet is one of the oldest and most respected peer-reviewed medical journals in the world, published weekly by Elsevier, part of Reed Elsevier. ...
A mental illness or mental disorder refers to one of many mental health conditions characterized by distress, impaired cognitive functioning, atypical behavior, emotional dysregulation, and/or maladaptive behavior. ...
Persistent pulmonary hypertension Persistent pulmonary hypertension (PPHN) is a serious and life-threatening lung condition that occurs soon after birth of the newborn. newborn babies with PPHN have high pressure in their lung blood vessels and are not able to get enough oxygen into their bloodstream. About 1 to 2 babies per 1000 babies born in the U.S. develop PPHN shortly after birth, and often they need intensive medical care. PPHN issix times more common in babies whose mothers take an SSRI antidepressant after the 20th week of the pregnancy compared to babies whose mothers do not take an antidepressant.[34] In medicine, pulmonary hypertension (PH) is an increase in blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting, and other symptoms, all of which are exacerbated by exertion. ...
“Baby†redirects here. ...
f you all The blood vessels are part of the circulatory system and function to transport blood throughout the body. ...
A physician visiting the sick in a hospital. ...
Interaction with carbohydrate metabolism Serotonin is also involved in regulation of carbohydrate metabolism. Few analyses of the role of SSRIs in treating depression cover the effects on carbohydrate metabolism from intervening in serotonin handling by the body. The smooth endoplasmic reticulum is responsible for some carbohydrate metabolism. ...
Overdose -
SSRIs appear to be safer in overdose when compared with traditional antidepressants such as the tricyclic antidepressants. This relative safety is supported both by case series and studies of deaths per numbers of prescriptions.[35] However, case reports of SSRI poisoning have indicated that severe toxicity can occur[36] and deaths have been reported following massive single ingestions,[37] although this is exceedingly uncommon when compared to the tricyclic antidepressants.[35] Serotonin syndrome is a rare, but potentially life-threatening adverse drug reaction that results from intentional self-poisoning, therapeutic drug use, or inadvertent interactions between drugs. ...
A drug overdose occurs when a chemical substance (i. ...
Because of the wide therapeutic index of the SSRIs, most patients will have mild or no symptoms following moderate overdoses. The most commonly reported severe effect following SSRI overdose is serotonin syndrome; serotonin toxicity is usually associated with very high overdoses or multiple drug ingestion.[38] Other reported significant effects include coma, seizures, and cardiac toxicity.[35] The therapeutic index of a medication is a comparison of the amount that causes the therapeutic effect to the amount that causes toxic effects. ...
Serotonin syndrome is a rare, but potentially life-threatening adverse drug reaction that results from intentional self-poisoning, therapeutic drug use, or inadvertent interactions between drugs. ...
For other uses, see Coma (disambiguation). ...
This article is about the medical condition. ...
Cardiotoxicity is the occurrence of heart muscle damage. ...
Treatment for SSRI overdose is mainly based on symptomatic and supportive care. Medical care may be required for agitation, maintenance of the airways, and treatment for serotonin syndrome. ECG monitoring is usually indicated to detect any cardiac abnormalities. ECG may also refer to the East Coast Greenway Lead II An Electrocardiogram (ECG or EKG, abbreviated from the German Elektrokardiogramm) is a graphic produced by an electrocardiograph, which records the electrical voltage in the heart in the form of a continuous strip graph. ...
Criticism - See also: Biopsychiatry controversy and Biological psychiatry
In late 2004 media attention was given to a proposed link between SSRI use and juvenile suicide. For this reason, the use of SSRIs in pediatric cases of depression is now recognized by the FDA as warranting a cautionary statement to the parents of children who may be prescribed SSRIs by a family doctor. The FDA's currently required packaging insert for SSRIs includes a warning (known as a "black box warning") that a pooled analysis of placebo controlled trials of 9 antidepressant drugs (including multiple SSRIs) resulted in a risk of suicidality that was twice that of placebo. At the same time, in adults SSRIs do not increase the risk of suicide.[39] This article is an expansion of a section entitled Criticism from within the main article: Biological psychiatry The debate about psychiatrys political implications is discussed in Anti-psychiatry The biopsychiatry controversy is an ongoing dispute over the scientific basis of biological psychiatry theory and practice. ...
Biological psychiatry, or biopsychiatry is an approach to psychiatry that aims to understand mental disorder in terms of the biological function of the nervous system. ...
Image File history File links Emblem-important. ...
Teenage suicide is the self-killing of a teenager. ...
A general practitioner (GP), family physician or family practitioner (FP) is a medical doctor who provides primary care. ...
It has been suggested that this article or section be merged with Black_Box_Warning. ...
A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicines or medical procedures. ...
For other uses, see Placebo (disambiguation). ...
Critics of SSRIs claim that the widely-disseminated television and print advertising of SSRIs promotes an inaccurate message, oversimplifying what these medications actually do and deceiving the public.[40]
The criticism stems from questions about the validity of claims that SSRIs work by 'correcting' chemical imbalances. Without accurately measuring patients' neurotransmitter levels to allow for continuous monitoring during treatment, it is impossible to know if one is correctly targeting a deficient neurotransmitter (i.e. correcting an imbalance), reaching a desirable level, or even introducing too much of a particular neurotransmitter. Thus it has been argued that SSRIs can actually cause chemical imbalances and abnormal brain states. Hence it is purported that when a patient discontinues an SSRI, they may have a chemical imbalance due to the rapid cessation of the drug which is causing the discontinuation syndrome.[41] Chemical imbalance is a term sometimes used by drug companies [1] in the United States in advertising and consumer literature for psychoactive drugs after the deregulation of pharmaceutical advertising. ...
Chemical structure of D-aspartic acid, a common amino acid neurotransmitter. ...
One possible mechanism is by inhibition of dopaminergic neurotransmission.[42] For other uses, see Dopamine (disambiguation). ...
Biopsychiatrists believe that, among other factors, the balance of neurotransmitters in the brain is a biological regulator of mental health. In this theory, emotions within a "normal" spectrum reflect a proper balance of neurochemicals, but abnormally extreme emotions, such as clinical depression, reflect an imbalance. Psychiatrists claim that medications regulate neurotransmitters, and many if not most psychiatrists also claim they treat abnormal personalities by removing a neurochemical excess or replenishing a deficit (though the efficacy of antidepressants and antipsychotics is not undisputed[43]). On the other hand, Elliot Valenstein, a psychologist and neuroscientist, claims that the broad biochemical assertions and assumptions of mainstream psychiatry are not supported by evidence.[44] Chemical structure of D-aspartic acid, a common amino acid neurotransmitter. ...
The human brain In animals, the brain (enkephalos) (Greek for in the skull), is the control center of the central nervous system, responsible for behavior. ...
Mental health is a term used to describe either a level of cognitive or emotional wellbeing or an absence of mental illness. ...
On the Threshold of Eternity. ...
An antidepressant is a medication used primarily in the treatment of clinical depression. ...
The term antipsychotic is applied to a group of drugs used to treat psychosis. ...
Elliot S. Valenstein, Ph. ...
One controversial critic of antidepressants, Peter Breggin, a physician who opposes the overuse of prescription medications to treat patients for mental health issues, predicted iatrogenic issues that SSRIs incur on a significant percentage of patients. Another prominent SSRI critic is David Healy. Peter R. Breggin is a controversial psychiatrist from the United States. ...
An iatrogenic (pronounced , IPA) condition is a state of ill health or adverse effect caused by medical treatment, usually due to mistakes made in treatment. ...
David Healy is an Irish psychiatrist who is currently Reader in Psychological Medicine at Cardiff University College of Medicine, Wales. ...
Lawsuits In one of the only three cases to ever go to trial for SSRI indication in suicide, Eli Lilly was caught corrupting the judicial process by making a deal with the plaintiff's attorney to throw the case, in part by not disclosing damaging evidence to the jury. The case, known as the Fentress Case involved a Kentucky man, Joseph Wesbecker, on Prozac, who went to his |
