Selective Serotonin Reuptake Inhibitors

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Of all three groups of antidepressants, the SSRI group (see Table 5.2) has the poorest profile for pain relief (APS, 2006). When compared with placebo, these medications did not have any significant advantage for pain relief. Given the lack of efficacy for pain relief in these medications and the profile of side effects, sexual dysfunction, anxiety, sleep disorder, and headache, the SSRIs are not medications that should be given unless there is a specific indication for use. The recommended use for this group of medications is for patients who have concurrent depression, anxiety, or insomnia (APS, 2008).

Table 5.2 ■ Selective Serotonin Reuptake Inhibitors

Common SSRIs

Starting Dose

Effective Dose

paroxetine (Paxil)

10-20 mg daily

20-40 mg daily

Citalopram (Celexa)

10-20 mg daily

20-40 mg daily

Selective Serotonin and Norepinephrine Reuptake Inhibitors 109

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