What is the Best SSRI for Anxiety, Types, Side Effects & Anxiety Treatment
What Is SSRI for Anxiety?
Anxiety disorders are the most common and among the most disabling of mental disorders in adults.
Exposure of the general population to a 1:4 lifetime risk of disabling anxiety has inspired generations of fundamental and clinical psychopharmacologists, from the era of the earliest benzodiazepines (BZ) to that of the selective serotonin reuptake inhibitors (SSRIs) and related compounds, eg, the serotonin and norepinephrine reuptake inhibitors (SNRIs).
It has been estimated by the Epidemiological Catchment Area (RCA) study  that approximately one-quarter of people will experience severe symptoms, disability, and handicap as a consequence of anxiety disorders at some time during their lifetime. These disorders are associated with significant morbidity and increased mortality, probably as a consequence of increased suicide rates among sufferers.
The spectrum of anxiety disorders includes generalized anxiety disorder (GAD), panic disorder (PD) and agoraphobia, obsessive-compulsive disorder (OCD), phobic disorder (including social phobia), and posttraumatic stress disorder (PTSD). With the discovery of new psychotropic medications, specific diagnosis within this spectrum is essential because each of these disorders responds to specific pharmacotherapy. The approach to anxiety should also recognize that anxiety and depression are often comorbid conditions.
How Does SSRI for Anxiety Work?
Selective serotonin reuptake inhibitors (SSRIs), which were designed to treat depression, are also effective for many anxiety disorders. They have revolutionized the treatment of anxiety, replacing the chronic use of benzodiazepines (BZs). SSRIs are effective for OCD, PDs, phobias, PTSD, and GAD. Other antidepressants, including tianeptine, have proven effective in adjustment disorders in which both anxiety and depression are involved. Doses of SSRIs for anxiety disorders could be higher than those used for depression but must be started at lower doses to minimize the short-term agitation sometimes experienced with these medications. The patient should be counseled that side effects often diminish with time and also that empirical switching to another SSRI may be necessary.
BZs are the oldest, class of medications used to treat anxiety. Although they have the advantage of rapid onset of action, they carry the risk of dependence, sedation, and tolerance. Withdrawal syndromes resulting in rebound anxiety, even reactions as severe as delirium tremens, are possible. BZs should be avoided in patients with a past, history of substance abuse, personality disorder, or dosage escalation. These medications are ideal for patients who experience infrequent bouts of anxiety or episodes of anxiety-related insomnia.
Types of SSRI For Anxiety
The FDA is in charge of deciding which medications are safe and effective for which reasons. The following SSRIs are approved to treat depression, anxiety, and other mood disorders:
- Citalopram (Celexa): Citalopram, sold under the brand name Celexa among others, is an antidepressant of the selective serotonin reuptake inhibitor class. It is used to treat major depressive disorder, obsessive compulsive disorder, panic disorder, and social phobia. The antidepressant effects may take one to four weeks to occur.
- Escitalopram (Lexapro): Escitalopram, sold under the brand names Cipralex and Lexapro, among others, is an antidepressant of the selective serotonin reuptake inhibitor class. Escitalopram is mainly used to treat major depressive disorder or generalized anxiety disorder. It is taken by mouth.
- Fluoxetine (Prozac): Fluoxetine, sold under the brand names Prozac and Sarafem among others, is an antidepressant of the selective serotonin reuptake inhibitor class. It is used for the treatment of major depressive disorder, obsessive–compulsive disorder, bulimia nervosa, panic disorder, and premenstrual dysphoric disorder.
- Fluvoxamine (Luvox, Luvox CR): Luvox CR is a prescription medicine used to treat the symptoms of Obsessive-Compulsive Disorder. Luvox CR may be used alone or with other medications.
- Paroxetine (Paxil, Paxil CR): Paroxetine is used to treat depression, panic attacks, anxiety disorders, and a severe form of premenstrual syndrome (premenstrual dysphoric disorder). It works by helping to restore the balance of a certain natural substance (serotonin) in the brain.
- Sertraline (Zoloft): Sertraline, sold under the brand name Zoloft among others, is an antidepressant of the selective serotonin reuptake inhibitor class. The efficacy of sertraline for depression is similar to that of other antidepressants, and the differences are mostly confined to side
- : Vilazodone, sold under the brand name Viibryd among others, is a medication used to treat major depressive disorder. While it was being studied for generalized anxiety disorder, such research had stopped as of 2017. It is taken by mouth. Common side effects include nausea, diarrhea, and trouble sleeping.
SSRI for Social Anxiety
Selective serotonin reuptake inhibitors (SSRIs) are usually the first choice of medication for treating social anxiety disorder (SAD). SSRIs affect your brain chemistry by slowing the reabsorption of the neurotransmitter serotonin, a chemical that we think helps to regulate mood and anxiety. 
Three SSRIs, Paxil, Zoloft, and Luvox CR have been approved by the FDA for treating social anxiety disorder. All three medications have been shown in clinical studies to offer improvement of symptoms.
Paxil was the first SSRI to receive FDA approval and is still often prescribed. However, the medication that works for one person doesn’t always work for another. So, your doctor will work with you to find the right prescription for you.
SSRI for Anxiety and Depression
Selective serotonin reuptake inhibitors (SSRIs) are a class of medications most commonly prescribed to treat depression. They are often used as first-line pharmacotherapy for depression and numerous other psychiatric disorders due to their safety, efficacy, and tolerability.
SSRI for Anxiety currently has FDA labeled indications  to treat the following conditions:
- Major depressive disorder
- Generalized anxiety disorder
- Bulimia nervosa
- Bipolar depression
- Obsessive-compulsive disorder
- Panic disorder
- Premenstrual dysphoric disorder
- Treatment-resistant depression
- Post-traumatic stress disorder
- Social anxiety disorder
Other off-label uses include but are not limited to: Binge eating disorder, Body dysmorphic disorder, fibromyalgia, premature ejaculation, paraphilias, autism, Raynaud phenomenon, and vasomotor symptoms associated with menopause.
How Long Do They Take to Work?
SSRIs are only available orally and come in multiple forms, including tablets, capsules, or liquid suspension/solution. There are currently no parenteral (IV, IM, SubQ), rectal, or other forms of SSRIs. SSRI administration is typically once-daily medication in the morning or nighttime. Except for vilazodone, SSRIs may be taken without regard to food. Vilazodone should be administered with food.
The effect of SSRIs may take up to 6 weeks before the patients feel the effects of treatment. If patients tolerate the current dose well, the clinician can consider an increase in dosage after several weeks.
All patients under the age of 25 should be continually assessed for suicidal ideation and other unusual behaviors, as highlighted in the FDA black box warning for all SSRI medications.
Most people who use SSRI antidepressants don’t have major problems, but every kind of medical treatment carries some risk.  The possible side effects of these antidepressants include:
- Blurred vision
- Dry mouth
- Agitation or nervousness
- Feeling dizzy
- Pain in the joints or muscles
- Upset stomach, nausea, or diarrhea
- Reduced sexual desire
- Problems with erection or ejaculation
Some people, especially children, and young adults may be more likely to have suicidal thoughts when they take SSRIs. Studies show that when compared to results from taking a placebo, chances of having suicidal thoughts doubled — from between 1% and 2% to between 2% and 4% — when taking any kind of antidepressant, including an SSRI. If you have thoughts of hurting yourself while taking an SSRI, call 911.
There are also important safety issues to consider about SSRIs. Although it’s rare, if too much serotonin accumulates in your system, you can develop a condition called serotonin syndrome. This happens most often if two different medications that increase serotonin are combined.
SSRIs can also have dangerous interactions with some medicines, both prescription and over-the-counter, including herbs and supplements. Before starting on an SSRI, make sure to tell your doctor all the different kinds of medications and supplements you’re taking.
SSRI vs SNRI
The main difference between SSRIs and SNRIs is that SSRIs prevent the reuptake of serotonin and SNRIs prevent the reuptake of serotonin and norepinephrine. Serotonin and norepinephrine are substances that the brain uses to send messages from one nerve cell to another.
SSRIs are currently some of the most commonly prescribed medications. They are used to treat numerous conditions and may be used in many settings, not just in primary care or psychiatry. Patients may be on these medications for the long term. Therefore, it is essential to have accurate medication reconciliation by the entire interprofessional team, including clinicians, pharmacists, nursing staff, and other health professionals.
Is your anxiety is linked to an underlying health issue? Some anxiety signs and symptoms appear as the first indicators of your medical illness. Your doctor might suspect your anxiety that can cause a medical issue and he or she may order tests to look for official diagnosis. 
- Drug misuse or withdrawal
- Thyroid problems, such as hyperthyroidism
- Chronic pain or irritable bowel syndrome
- Heart disease
- Rare tumors that produce certain fight-or-flight hormones
- Respiratory disorders, such as chronic obstructive pulmonary disease and asthma
- Withdrawal from alcohol, anti-anxiety medications benzodiazepines or other medications
The standard way of treating anxiety is psychological counseling. This can include cognitive-behavioral therapy, psychotherapy, or a combination of therapies.
At the We Level Up FL Treatment Center, we provide world-class care with round-the-clock medical professionals available to help you cope. All working as a team providing anxiety treatment for successful recovery. Make this your opportunity to reclaim your life. Call today to speak with one of our treatment specialists. Our counselors know what you are going through and will answer any of your questions regarding the safe options for SSRI for anxiety.
Your call is private and confidential and there is never any obligation.
 Psychopharmacology of anxiety disorders – National Center for Biotechnology Information, U.S. National Library of Medicine
 How SSRIs Are Used to Treat Social Anxiety Disorder – https://www.verywellmind.com/how-are-ssris-used-in-social-anxiety-disorder-treatment-3024947
 Selective Serotonin Reuptake Inhibitors – National Center for Biotechnology Information, U.S. National Library of Medicine
 What Are SSRIs? – https://www.webmd.com/depression/ssris-myths-and-facts-about-antidepressants
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