Selective serotonin reuptake inhibitors (SSRIs): therapeutic drug monitoring and pharmacological interactions

Curr Med Chem. 2012;19(12):1846-63. doi: 10.2174/092986712800099749.

Abstract

New-generation antidepressants are a heterogeneous class of drugs used in the treatment of depression and related disorders. This review deals with the first new-generation antidepressant class to enter the pharmaceutical market, i.e., selective serotonin reuptake inhibitors (SSRIs), which are still the most prescribed and widely used ones. Their common characteristics are the comparable clinical efficacy, good tolerability and relative safety in comparison to "first generation antidepressants", i.e. classic tricyclic antidepressants and monoamine oxidase inhibitors. This class of drugs includes fluoxetine, citalopram, paroxetine, sertraline, fluvoxamine and, since 2011, vilazodone. In this review, the main pharmacodynamic and pharmacokinetic properties of the six commercially available SSRIs are described, focusing on side and toxic effects, chemical-clinical correlations, interactions with other drugs, the role of therapeutic drug monitoring (TDM) and related bioanalytical methodologies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Benzofurans / adverse effects
  • Benzofurans / pharmacokinetics
  • Benzofurans / therapeutic use
  • Citalopram / adverse effects
  • Citalopram / pharmacokinetics
  • Citalopram / therapeutic use
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / metabolism
  • Drug Monitoring*
  • Fluoxetine / adverse effects
  • Fluoxetine / pharmacokinetics
  • Fluoxetine / therapeutic use
  • Fluvoxamine / adverse effects
  • Fluvoxamine / pharmacokinetics
  • Fluvoxamine / therapeutic use
  • Humans
  • Indoles / adverse effects
  • Indoles / pharmacokinetics
  • Indoles / therapeutic use
  • Paroxetine / adverse effects
  • Paroxetine / pharmacokinetics
  • Paroxetine / therapeutic use
  • Piperazines / adverse effects
  • Piperazines / pharmacokinetics
  • Piperazines / therapeutic use
  • Serotonin Uptake Inhibitors / adverse effects
  • Serotonin Uptake Inhibitors / pharmacokinetics
  • Serotonin Uptake Inhibitors / therapeutic use*
  • Sertraline / adverse effects
  • Sertraline / pharmacokinetics
  • Sertraline / therapeutic use
  • Vilazodone Hydrochloride

Substances

  • Benzofurans
  • Indoles
  • Piperazines
  • Serotonin Uptake Inhibitors
  • Fluoxetine
  • Citalopram
  • Paroxetine
  • Fluvoxamine
  • Sertraline
  • Vilazodone Hydrochloride