Adverse Psychiatric Reactions Information Link
Promoting awareness of medicines that can harm mental health


SSRIs Antidepressants  are Selective Serotonin Re-uptake Inhibitors


If you are taking antidepressants, make sure you have regular blood tests to check your potasium levels and kidney and liver function.


If you are taking antidepressants, make sure you have regular blood tests to check your potasium levels and kidney and liver function.

 You should inform a family member or someone close to you if you start taking antidepressants. This is advised by manufacturers and the Royal Colleges and Department of Health - Please read the editorial in the medical journal Prescriber: This was compiled by Millie Kieve of APRIL and Janet Krska, Professor of Pharmacy

November 2015 editorial in Prescriber journal by Millie Kieve and Professor Janet Krska

Concensus Statement for Suicide Prevention from Department of Health and Royal Colleges

 The article explains the need for a family member or friend to be informed when antidepressants are prescribed: entitled The role of relatives and friends in antidepressant treatment: 

For antidepressant withdrawal and safe, slow reduction in dosage, a huge breakthrough is the Royal College of Psychiatrists have included, on their web site, detailed information about titrating the dosage, the use of liquid medication and other advice. They also warn about possibe withdrawal effects. This is a vital contribution towards patient safety, we have been begging for during the past 20 years.


Tips that may help you if you feel depressed

Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants used in the treatment of depression, anxiety disorders, and some personality disorders. The first class of psychotropic drugs to be rationally designed, SSRIs are the most widely prescribed antidepressants in many countries. Their effectiveness and safety have been questioned.

List od SSRIs click on name of drug (if blue colour) for more information

Citalopram (Celexa, Cipramil, Emocal, Sepram, Seropram)

escitalopram (Lexapro, Cipralex, Esertia)

fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem, Fluctin, Fluox)

fluvoxamine  (Luvox, Faverin, Dumyrox)

paroxetine  (Paxil, Seroxat, Aropax, Deroxat, Rexetin, Xetanor, Paroxat)

sertraline  (Zoloft, Lustral, Serlain)

zimelidine (Zelmid, Normud)

Psychiatric Adverse Side Effects (ADRs)

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). 

 Almost all SSRIs are known to cause one or more of these symptoms: 

Nausea, headache, extremely vivid and strange dreams, dizziness, changes in appetite, changes in sexual behaviour, increased feelings of depression and anxiety (which may sometimes provoke panic attacks), akathisia, suicidal ideation

However, despite being called general, the side effects and their durations are highly individual and drug-specific. 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.

Suicide and Aggression

Similarly to other antidepressants, it is commonly accepted that SSRIs can cause suicidality in children. We all know of adults affected in the same way. Analyses of the risks of SSRIs by governing bodies in the United States and United Kingdom have produced warnings about suicidality and aggression when the medications are used with children and adolescents.

A 2004 Food and Drug Administration (FDA) analysis of clinical trials on children with major depressive disorder found statistically significant increases of the risks of "possible suicidal ideation and suicidal behavior" by about 80%, and of agitation and hostility by about 130%. An additional analysis by the FDA also indicated 1.5-fold increase of suicidality in the 18 to 24 age group. This resulted in a black box warning on SSRI and other antidepressant medications regarding the increased risk of suicidality in patients younger than 24.

Review and Evaluation of Clinical DataDrugs, NDAs, 4/20/04Subject: Relationship between psychotropic drugs and pediatric suicidalityReviewer:

Tarek A. Hammad, M.D., Ph.D., M.Sc., M.S.

Date Review Completed: 8/16/04

This document analyzes and evaluates data submitted by sponsorsof several psychotropic drugs in response to FDA requestsregarding data pertinent to pediatric suicidality.

Several hyperlinks (seen underlined in blue color) were put in place to facilitate navigating through the document


Drugs, NDAs, sponsors:


1. Wellbutrin (Bupropion, GlaxoSmithKline

2. Remeron (mirtazapine), Organon

3. Luvox (fluvoxamine), Solvay,

4. Effexor and Effexor XR (venlafaxine), , Wyeth,

5. Zoloft (sertraline), Pfizer,

6. Celexa (citalopram), Forest,

7. Paxil (paroxetine), GlaxoSmithKline

8. Prozac (fluoxetine), Lilly,

9. Serzone (nefazodone), Bristol Myers Squibb,

Reviewer: Tarek A. Hammad, M.D., Ph.D., M.Sc., M.S.

Date Review Completed: 8/16/04

In 2004, the Medicines and Healthcare products Regulatory Agency (MHRA) in the United Kingdom judged fluoxetine (Prozac) to be the only antidepressant that offered a favorable risk-benefit ratio in children with depression, though it was also associated with an increase in the risk of self-harm and suicidal ideation. Only two SSRIs are licensed for use with children in the UK, sertraline (Zoloft) and fluvoxamine (Luvox), and only for the treatment of obsessive-compulsive disorder. Fluoxetine, despite having a favorable risk-benefit ratio for use with depression in adolescents and children, is not licensed for this use.

At APRIL we are aware of young people who died by suicide while taking Prozac

Seizures are a possible side effect of SSRI antidepressants and anti-smoking drugs and the link to the prescribed drug may not be recognised.


Withdrawal from antidepressant drugs

Always obtain medical advice and support if you are considering reduction of the dose of any antidepressant.

Your doctor should try to obtain the liquid form of the drug to enable you to titrate very slowly.

 SSRI drugs such as Seroxat / Paxil and Prozac have been causing problems for some time resulting in law suits which have been settled out of court.

The habit forming nature of SSRI  and similar antidepressant drugs has not been disclosed in an open truthful manner. There are many people, unable to withdraw without severe mental and physical distress. This often results in the patient being told that they are having a relapse when in fact they are suffering serious withdrawal symptoms.

Related Articles and Links

Information provided by US Law Firm Baum Hedlund including testimonies to the FDA from families about the effect of these drugs on their children. These testimonies influenced the FDA to issue warnings about the risk of suicide.

 SSRI stories in the press

 If you have or know of a case reported in the press concerning SSRI, SNRI and similar antidepressants please submit this to:


Reporting Adverse Drug Reactions (ADRs)
If you have suffered psychiatric adverse reactions please report them. There may be side effects not mentioned on the data sheets. You can request a list of drugs used pre surgery and during surgery. You should be given patient information for all drugs prescribed as you are discharged from hospital.

Please report Adverse Drug Reactions (ADRs) to:

UK Yellow Card Reporting for Patient and Health Professional reports of Adverse Drug Reactions

USA and worldwide to the Food and Drug Administration for Patients and Healthcare Professionals

Universal free, independent drug safety website - Rxisk

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