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Alzheimer's Disease and SSRIs

Read more about SSRIs.

Overview

Antidepressants, specifically Selective serotonin reuptake inhibitors (SSRIs) are sometimes prescribed for treatment of Alzheimer's symptoms. At least 25% of people with Alzheimer’s disease have depression.

Selective serotonin reuptake inhibitors (SSRIs) prescribed for Alzheimer’s disease include:

  • Citalopram (Celexa)
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)

Effect of SSRIs on Alzheimer's Disease

Antidepressants are used to treat low mood, depression, anxiety, and irritability. The antidepressants prescribed for Alzheimer’s disease belong to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). SSRIs work by increasing the activity of the chemical serotonin in the brain.

Side Effects and Warnings

Possible side effects of SSRIs include:

  • Drowsiness
  • Dryness of mouth
  • Blurred vision
  • Nausea
  • Dizziness
  • Difficulty sleeping
  • Sexual dysfunction
  • Risk of severe mood and behavior changes
  • Suicidal thoughts and actions

Gastrointestinal upset is the most common side effect that users experience. These include nausea, diarrhea, and cramping. It is commonly recommended that users take SSRIs with food and an antacid or antiemetic for the first 2-3 weeks of treatment.

SSRIs also activate the central nervous system, which can result in agitation, anxiety, restlessness, and insomnia.

FDA issued a warning that combining an SSRI with one of the commonly-used "triptan" medications for migraine headaches can cause serious side effects such as agitation, hallucinations, elevated body temperature, and rapid changes in blood pressure. (6)

Other side effects can include headache, dry mouth, excessive sweating, tremor, and sexual dysfunction.

Do not take selective serotonin inhibitors (SSRIs) with monoamine inhibitors (MAOIs).

The first SSRI on the market was fluoxetine (Prozac). The newer agents are: citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft).8 They all share the same side effects but in varying degrees. Unlike TCAs, they interact very little with other receptors besides the serotonin 5-HT reuptake receptor. Their side effects tend to be related to increased serotonin activity: nausea, gastrointestinal upset, sweating, anxiety, insomnia, headache, restlessness, and sexual dysfunction. This class of drugs is prescribed for mild to moderate depression.8

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