SSRIs+and+OCD

**SRIs and SSRIs**

The main class of drugs used to treat obsessive compulsive disorder (OCD) are serotonin reuptake inhibitors (SRIs) and the selective serotonin reuptake inhibitors (SSRIs). (CAMH, 2001) The SSRIs are the newer of the two and the more commonly prescribed of the two. They primarily affect serotonin neurotransmitters which is one of the main transmitters involved in OCD. (CAMH, 2001) According to CAMH, Clomipramine (Anafranil) is one of the oldest SRI’s and is so effective that about 80% of people show a reduction in OCD symptoms while taking the drug. It is also noted that Clomipamine has more side effects than the SSRIs and are usually prescribed second due to this reason. (CAMH, 2001)
 * SSRIs in Canada **(CAMH, 2001)

Fluoxetine (Prozac) Fluvoxamine (Luvox) Sertraline (Zoloft) Paroxetine (Paxil) Citalopram (Celexa).

** Selecting a Drug/Dosage ** SSRIs are taken on a daily basis. The dosage is always started at the smallest effective dose and then increased as needed. There are many side effects associated with SRIs which must also be considered when choosing the correct dosage. (CAMH, 2001) For best results, SRIs should be taken regularly, generally once each day. Most doctors recommend starting at a low dose and then, if the patient tolerates the medication well, slowly increasing the dose. People who take SSRIs may experience many side effects; therefore the ideal dose is one that provides the greatest benefit with a minimum of side effects. SRIs can take a few weeks for a therapeutic level of the drug to build up in the human body. This means that relief from symptoms may not be seen right away on the drug. As previously mentioned, if a person does not benefit from the first medication, a second choice may be clomipramine. (CAMH, 2001) It is often common for people to try multiple drugs in the SSRI family before finding one that works for them. (CAMH, 2001)

** How SSRIs work **

SSRIs work by attaching to and affecting the presynaptic membrane, blocking the reabsorption (reuptake) of the neurotransmitter serotonin. This allows serotonin to build up in the synapse and produces the desired effect of an elevated mood. The term “selective” is given to SSRIs because they only have this effect of serotonin receptors. (Mayo Clinic, 2011)



** Stopping an SSRI ** <span style="font-family: arial,helvetica,sans-serif; font-size: 16px;">Often times, people may wish to stop taking an SSRI. Consultation with a doctor is the recommended practice when stopping any drug. The best way to do this is by gradually tapering off the dosage and replacing the medication with other types of therapy, such as CBT. (CAMH, 2001)

<span style="font-family: Arial,Helvetica,sans-serif;">** Some Side-Effects of <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">S **<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">**SRIs**  <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">(CAMH, 2001)


 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 16px;">Dry mouth
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 16px;">Sweating
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 16px;">Constipation
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 16px;">Drowsiness and nausea
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 16px;">Tremor
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 16px;">Sexual issues such as low sex drive
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 16px;">Weight gain (Clomipramine)
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 16px;">Headaches
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 16px;">Rash
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 16px;">Insomnia