SSRI Antidepressants: What They Do and What to Expect

SSRIs (selective serotonin reuptake inhibitors) are a common first choice for depression and many anxiety disorders. They work by raising serotonin levels in the brain, which can help mood, sleep, and worry. You’ve probably heard names like Lexapro (escitalopram), sertraline, fluoxetine, citalopram, and paroxetine — these are the usual suspects.

What to expect when you start an SSRI

Don’t expect overnight change. Most people begin to feel small improvements in 1–2 weeks, with clearer benefits by 4–8 weeks. Early changes often involve better sleep or less anxiety before mood lifts. Side effects are common at first: nausea, headache, mild insomnia or sleepiness, and sexual side effects. If side effects stick or get worse after a few weeks, talk to your prescriber—there are ways to switch drugs or adjust dose.

If you’re reading about Lexapro specifically, our Lexapro article covers doses, real user experiences, and tips for handling side effects. That’s a good next read if your doctor suggested escitalopram.

Safety, interactions and quick tips

Mixing meds matters. SSRIs can interact with blood thinners like warfarin, some painkillers, and several antidepressants, raising bleeding or serotonin syndrome risk. If you take Coumadin/warfarin or frequent NSAIDs, get medical advice before adding an SSRI. Always tell your doctor every medication and supplement you use.

Tapering matters too. Stopping an SSRI suddenly can cause dizziness, flu-like symptoms, or mood shifts. Most prescribers recommend a gradual taper under supervision. If you ever feel unusual symptoms after stopping or changing a dose, contact your clinician right away.

Practical tips that help: keep a short daily log of mood, sleep, and side effects for the first 8–12 weeks; plan follow-ups at 2–4 weeks and again at 6–8 weeks; avoid alcohol while you’re adjusting; and be patient — finding the right drug and dose can take time.

Not all antidepressants are SSRIs. If an SSRI doesn’t help, options include SNRIs (like duloxetine), atypical antidepressants, or therapy. We have a piece on alternatives to duloxetine if you’re exploring other meds in 2025.

If you’re managing other conditions—like migraines, heart meds, or clotting issues—work with your doctor to pick a safe option. SSRIs help many people, but the right choice depends on your symptoms, side effects, and other health factors. Read the related posts on this tag to compare drugs and find practical, up-to-date advice that fits your situation.