SSRIs (selective serotonin reuptake inhibitors) - Side effects 

Side effects of SSRIs 

Reporting side effects

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine that you are taking. It is run by a medicines safety watchdog called the Medicines and Healthcare products Regulatory Agency (MHRA). See the website of the Yellow Card Scheme for more information.

The side effects of selective serotonin reuptake inhibitors (SSRIs) can be troublesome at first but generally improve with time.

It is important to persist with treatment, even if you are affected by side effects, as it will take several weeks before you begin to benefit from treatment.

With time you should find the benefits of treatment outweigh problems related to side effects.

Common side effects

Common side effects of SSRIs, affecting around one in 10 people include:

These side effects should improve over time, although some can occasionally persist.

Less common side effects

Up to one person in 100 may experience the following:

  • bruising or bleeding, including vomiting blood or blood in your stools (speak to your GP or go to hospital straight away)
  • confusion
  • problems with movement, stiffness, shaking or abnormal movements of the mouth
  • hallucinations (seeing or hearing things that are not real)
  • being unable to pass urine (speak to your doctor or go to hospital straight away)
  • being sick
  • weight gain

Serotonin syndrome

Serotonin syndrome is an uncommon, but potentially serious, set of side effects linked to SSRIs.

Serotonin syndrome occurs when levels of serotonin in your brain become too high. It is usually triggered when you take an SSRI in combination with another medication (or substance) that also raises serotonin levels, such as another antidepressant or St John’s wort.

Symptoms of serotonin syndrome include:

  • confusion
  • agitation
  • muscle twitching
  • sweating
  • shivering
  • diarrhoea

You should stop taking the medication and seek immediate advice from your GP if you experience these symptoms. If this is not possible, call NHS Direct on 0845 46 47.

Symptoms of severe serotonin syndrome include:

  • a very high temperature (fever) of 39.4°C (103°F) or above
  • seizures (fits)
  • irregular heartbeat (arrhythmia)
  • unconsciousness

Hyponatraemia

A drop in levels of sodium (salt) is a side effect that occurs in elderly people. This is known as hyponatraemia. It leads to a build-up of fluid inside the cells of the body, which can be potentially dangerous.

Mild hyponatraemia can cause the following symptoms:

  • feeling sick
  • headache
  • muscle pain
  • reduced appetite
  • confusion

Severe hyponatraemia can cause the following:

  • feeling listless and tired
  • disorientation
  • agitation
  • psychosis (being unable to tell the difference between reality and your imagination)
  • seizures (fits)

In the most serious cases it can cause:

  • coma 
  • stopping breathing

If you suspect that you (or someone in your care) has mild hyponatraemia, call your GP for advice.

If you suspect severe hyponatraemia, call 999 and ask for an ambulance.

If it is thought you may be at risk your sodium levels may be measured before you begin taking SSRIs and then for a number of weeks afterwards (most cases of SSRI-related hyponatraemia occur in the first weeks of treatment). Sodium levels can be measured using a blood test.

Antidepressants and suicide risk

Some people have experienced suicidal thoughts and a desire to self-harm when they start taking SSRIs. Those under 25 years of age seem particularly at risk.

Contact your GP, or go to hospital immediately, if you have thoughts of killing or harming yourself at any time while taking SSRIs (or other antidepressants).

It may be useful to tell a relative or close friend you have started taking antidepressants and ask them to read the leaflet that comes with your medication. You should then ask them to tell you if they think your symptoms are getting worse, or if they are worried about changes in your behaviour. 

 

Page last reviewed: 24/04/2012

Next review due: 24/04/2014

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Comments

The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

haldi said on 03 November 2013

By all internet accounts this drug is scarey.
I am afraid that I agree
I am now attempting to get off it, by gradually reducing the dose.
It was originally prescribed three months ago for neuropathic pain. Starting the medicine made me very unwell, experiencing extreme nausea, complete loss of appetite and bad anxiety.
Most of these side effects went away after 2 weeks, but were replaced by excessive sweating, sores on my head, hair loss, terrible headaches, migraine and over excitement.
In fairness to the drug I did get a good week whilst on the medication, but that may simply be something I would have experienced anyhow

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Always read the information leaflet

This is not a complete list of all reported side effects of SSRIs, so it is always important to read the patient information leaflet that comes with your medication.

The Yellow Card Scheme

The MHRA has produced a video that explains how the Yellow Card Scheme can be used to report the side effects of medication