SSRI drugs are used for the treatment of depression and generalized anxiety disorders. The term SSRI is abbreviation for 'selective serotonin reuptake inhibitor'. These drugs increase the availability of serotonin, the mood-influencing neurotransmitter, in brain cells. Since a fall in the availability of serotonin to brain cells is the primary somatic reason for depression and anxiety, the increase in its availability as a result of SSRI action helps improve mood and reduce anxiety. Examples of SSRIs are: Lexapro, Celexa, Paxil, Zoloft, and Effexor among others.
Drugs of choice: SSRIs are considered the drugs of choice for the treatment of mood and anxiety disorders because they specifically act on the serotonin level in brain cells. They do not significantly interfere with other physiological processes, nor do they have any life-threatening interactions with other drugs (except other categories of anti-depressants such as monoamine oxidase inhibitors). SSRIs also do not potentiate any other drug. Therefore, if taken under medical prescription, SSRI are nowadays preferred to older groups of anti-depressants.
Side-effects: However, they do cause side-effects, but they are unpredictable. Most side-effects of SSRIs are usually mild and manageable though irritating, and disappear when treatment is tapered off. However, if the patient already has some medical problem before the start of treatment for depression, it would be strongly advisable to inform the doctor accordingly. One such problem which your doctor must know (if you have that problem) is those relating to the renal (urinary) system.
Impact on renal system: they must be prescribed with care for patients having a renal problem. It is not known why and how SSRIs affect the renal system; but it has been seen that these drugs reduce the efficiency of the renal function in patients with an existing renal condition.
In patients with mild-to-moderate renal impairment, oral clearance of Lexapro (the latest SSRI drug) is reduced by 17 per cent. This does not necessarily mean that such patients should not take SSRIs or that they should take a lower dosage.
However, for patients with a severe renal impairment, they should be prescribed with great caution. A definition of this 'great caution' does not exist, and the best judge is the physician who will first study the severity of the patient's renal condition and probably prescribe a smaller dose than the normal 10-20mg per day.
To conclude, most side-effects of SSRIs are reversible, including their side-effects on the renal system. No permanent damage is known to be caused. Yet, they can complicate renal conditions if taken by patients with severe renal impairment. In such a situation, the physician will most probably prescribe a lower dosage of an SSRI if simultaneous treatment of the patient's mental condition is also necessary.
