Decision box

SSRIs are a class of medications that are taken daily to reduce the symptoms of depression. These medications (Citalopram [Celexa®], Escitalopram [Cipralex®], Fluoxetine [Prozac®], Fluvoxamine [Luvox®], Paroxetine [Paxil®], Sertraline [Zoloft®]) act by selectively inhibiting the uptake of serotonin.

Adults diagnosed with moderate to severe unipolar depression. Diagnosis can be made using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
 

There are pros and cons to taking this medication:

• PROS: Individuals with moderate to severe depression who take SSRIs for 4-8 weeks experience a small but clinically significant reduction in their symptoms using the Hamilton Rating Scale of Depression see below).
• CONS: 85% of individuals treated with SSRIs experience at least one bothersome side effect, and 1-5% of individuals discontinue treatment because of reversible side effects such as sexual dysfunction and insomnia. Moreover, in the trials to evaluate the effectiveness of SSRIs, the lengths of treatment were relatively short. There is a lack of evidence on the effects of long term SSRI treatment.

Moderate and severe depression can also be treated with exercise, behavioural and psychotherapy approaches, and other medications such as tricyclic antidepressants and St. Johns wort.

Download the test

• 17 to 21 item questionnaire to rate depression severity
• range: 0-50
• score > 18 indicates severe depression
• 3-point change: clinically significant