Common SSRIs Compared
| SSRI | Typical Dose | Main Uses | Notes |
|---|---|---|---|
| Sertraline | 50–200 mg | Depression, anxiety, PTSD, OCD | Most versatile, widely used |
| Fluoxetine | 20–60 mg | Depression, bulimia, OCD | Long half-life — easiest to stop |
| Citalopram | 20–40 mg | Depression | Simple, few drug interactions |
| Escitalopram | 10–20 mg | Depression, anxiety | Slight improvement on citalopram |
| Paroxetine | 20–60 mg | Depression, anxiety, PTSD | Short half-life — harder to stop |
First 2 WeeksSSRIs can temporarily increase anxiety and agitation in the first 1–2 weeks. Do not stop. This usually settles. Contact your doctor or mental health team if you feel significantly worse or have thoughts of self-harm.
Timeline: What to Expect
| Timeframe | What Happens |
|---|---|
| Days 1–3 | Possible nausea, headache, restlessness |
| Week 1–2 | Side effects may peak — anxiety, insomnia common |
| Week 2–4 | Side effects usually settle; sleep often improves first |
| Week 4–6 | Mood starts to lift — motivation returns |
| Week 6–8 | Full antidepressant effect usually achieved |
| 6–12 months | Recommended minimum treatment duration after recovery |
Common Side Effects
- Nausea (usually settles after 1–2 weeks — take with food)
- Insomnia or excessive drowsiness (depends on person)
- Sexual side effects (reduced libido, delayed orgasm) — affects 30–40%
- Headache
- Dry mouth
- Sweating
Sexual Side EffectsSexual dysfunction from SSRIs affects about 1 in 3 people but is rarely discussed. It doesn't always resolve. Options include waiting, dose reduction, switching to bupropion or mirtazapine (lower risk), or adding another medication. Always discuss with your prescriber.
How to Stop an SSRI Safely
- Never stop abruptly — this causes discontinuation syndrome (dizziness, electric shock sensations, flu-like symptoms)
- Taper dose over 4–8 weeks minimum (longer if on medication >1 year)
- Fluoxetine can often be stopped more quickly due to its long half-life
- If symptoms return during taper, slow down and discuss with your doctor
How long should I take an antidepressant?
NICE and most guidelines recommend at least 6 months after feeling well. For recurrent depression (3+ episodes), long-term or indefinite treatment is often recommended.
Will antidepressants change my personality?
SSRIs treat depression — they help you feel like yourself again. Most people report that they feel 'normal', not sedated or blunted. If you feel emotionally numb, discuss dose adjustment.
Can I drink alcohol on SSRIs?
Alcohol is a depressant and worsens depression. It can also increase sedation and impair your response to treatment. While not absolutely forbidden, minimising alcohol is strongly advised.
Do SSRIs cause weight gain?
Some SSRIs cause modest weight gain (1–3 kg) with long-term use, but this varies. Paroxetine has the highest risk; fluoxetine may initially cause weight loss.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.