Selective Serotonin Reuptake Inhibitors (SSRIs) are considered safer than older antidepressants, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), due to several reasons:
Selective mechanism: SSRIs specifically target the reuptake of serotonin, a neurotransmitter associated with mood regulation, while older antidepressants, like TCAs, affect the reuptake of multiple neurotransmitters, including serotonin, norepinephrine, and dopamine. This selectivity makes SSRIs more focused in their action and potentially reduces the risk of adverse effects.
Fewer side effects: SSRIs generally have a more favorable side effect profile compared to older antidepressants. TCAs and MAOIs often cause a wide range of side effects, including anticholinergic effects (dry mouth, constipation, blurred vision), sedation, weight gain, and cardiovascular issues. While SSRIs may also have side effects, they tend to be milder and more tolerable for most individuals.
Lower toxicity in overdose: TCAs, especially, have a higher risk of toxicity in cases of overdose, which can be life-threatening. In contrast, SSRIs have a wider safety margin, meaning they are less likely to cause severe toxicity even when taken in larger quantities.
Reduced risk of drug interactions: Older antidepressants like MAOIs have significant interactions with certain foods, beverages (e.g., aged cheese, wine) and other medications, leading to potentially dangerous interactions. SSRIs have a much lower risk of such interactions, making them safer to use in combination with other medications.
Improved compliance: SSRIs are usually taken once a day, while some older antidepressants may require multiple daily doses. The simpler dosing schedule of SSRIs improves compliance, reducing the risk of missed or irregular doses.
Lower risk of cardiac side effects: TCAs can have effects on the heart's conduction system, which can be problematic, especially for individuals with preexisting heart conditions. SSRIs, on the other hand, have a more favorable cardiac safety profile.
Despite these advantages, it's important to note that individual responses to antidepressants can vary, and what works well for one person may not be as effective or safe for another. Therefore, it's essential for individuals to work closely with their healthcare providers to determine the most suitable antidepressant based on their specific needs and medical history. Additionally, abrupt discontinuation of any antidepressant medication, including SSRIs, should be done under medical supervision, as sudden withdrawal can lead to withdrawal symptoms or potential relapse of depression.