TY - CHAP M1 - Book, Section TI - Serotonin Reuptake Inhibitors and Atypical Antidepressants A1 - Stork, Christine M. A2 - Hoffman, Robert S. A2 - Howland, Mary Ann A2 - Lewin, Neal A. A2 - Nelson, Lewis S. A2 - Goldfrank, Lewis R. PY - 2015 T2 - Goldfrank's Toxicologic Emergencies, 10e AB - In the United States, major depressive disorder is a leading cause of disability and affects 14.8 million American adults; it is also the largest cause of disability for adolescents and those 15 to 44 years of age.1,93 Although major depressive disorder can develop at any age, the median age at onset is 32 years and it is more prevalent in women.94,95 The exact etiology of depression and the mechanism by which increased serotonergic and norepinephrine neurotransmission modulates mood remains unclear. Antidepressants modulate the activity of serotonin and norepinephrine and dopamine to achieve their effect. The class of selective serotonin reuptake inhibitors (SSRIs) includes citalopram, escitalopram (active enantiomer of citalopram), fluoxetine, fluvoxamine, paroxetine, sertraline, and vilazodone (Fig. 75–1). Atypical antidepressants extend the pharmacologic principles of SSRIs to achieve beneficial effects for patients with depression. The SSRIs and atypical antidepressants comprise the current standard for the treatment of depression.80 SSRIs also are used to treat obsessive–compulsive disorders, panic disorders, alcoholism, obesity, and various nonpsychiatric disorders such as migraine headaches and chronic pain syndromes.11,125,131 They have excellent safety profiles when compared with monoamine oxidase inhibitors (MAOIs) and the cyclic antidepressants. Like many xenobiotics, the appropriateness of their use and the associated morbidity and mortality is questioned as the patient population has aged and the comorbidity profiles of those using the SSRIs have changed. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/16 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1108432303 ER -