they inhibit the reuptake of 5HT in the synaptic cleft, this improves patient mood.


Cardiac diseaseconcurrent electroconvulsive therapydiabetes mellitusepilepsy

elderly risk hyponatraemia less than 130 mmol

Patients should be withdrawn over a few weeks

Side effects 

Anxietyappetite abnormalarrhythmiasarthralgiaasthenia;

concentration impairedconfusionconstipation;



drowsinessdry mouthfevergastrointestinal discomfort


Withdrawal effects may occur within 5 days of stopping treatment with antidepressant drugs; they are usually mild and self-limiting, but in some cases may be severe.

The risk of withdrawal symptoms is increased if the antidepressant is stopped suddenly after regular administration for 8 weeks or more.

drug interactions 

SSRIs must not be taken with monoamine oxidase inhibitors as this can increase the risk of sertogenic syndrome.

If the patient is taking an SSRI with an anti-coagulant gastroprotection must be added.

Exam Tips 

Do not withdraw suddenly

Review elderly patients with hyponatraemia


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