NCLEX Review Guide: Selective Serotonin Reuptake Inhibitors (SSRIs)

How SSRIs Work

• SSRIs block the reuptake of serotonin at the synaptic cleft, increasing available serotonin in the brain to improve mood and reduce anxiety symptoms.
• Primary indication is major depressive disorder, but also effective for anxiety disorders, OCD, PTSD, and panic disorder.
• Therapeutic effects typically begin within 2-4 weeks of consistent use, with full benefits seen in 6-8 weeks.

Common Side Effects

• GI effects include nausea, diarrhea, and decreased appetite - usually subside within first few weeks of treatment.
• Sexual dysfunction affects 30-70% of patients and includes decreased libido, delayed orgasm, and erectile dysfunction.
• CNS effects include headache, dizziness, insomnia, and initial anxiety or agitation.
• Weight changes can occur - initial weight loss followed by potential weight gain with long-term use.

Critical Nursing Actions

1. Assess baseline mood, suicidal ideation, and anxiety levels using standardized tools
2. Monitor for increased suicidal thoughts especially in first 8 weeks of treatment
3. Educate patient about delayed onset of therapeutic effects to prevent discontinuation
4. Monitor electrolytes, particularly sodium levels in elderly patients
5. Assess for drug interactions, especially with MAOIs, warfarin, and other serotonergic drugs