In this This Is Why pharmacology review, Dr. Busti walks through the Selective Serotonin Reuptake Inhibitors (SSRIs)—how they became first-line for major depressive disorder and a wide range of anxiety-related disorders, and where their real-world pitfalls live.

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We compare the core agents—citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline—covering indications, mechanism, and clinical nuances that matter at the bedside. You’ll learn how dose, half-life, metabolism, and side-effect patterns influence patient-specific choices, and what to monitor for safety and success.

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This episode includes practical guidance on:

• Managing sexual dysfunction, QT risk, and SIADH
• Recognizing CYP2D6 interactions
• Understanding fluoxetine’s long half-life
• Applying MAOI washout rules to avoid serotonin syndrome
• Starting low and titrating slow for anxiety

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If you want to go beyond memorization and understand the why behind the what, this episode connects the science, safety, and strategy of SSRI use.

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Disclaimer:
This content is for educational purposes only and is not intended to provide medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard in this content.

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Chapters:
0:00 Welcome & Why SSRIs Still Matter
2:30 The Roster and Common Uses
6:10 Mechanism Refresher – Reuptake Inhibition
9:00 Clinically Relevant Differences
14:30 Safety and Side Effects You’ll Actually See
19:20 Interactions and Washouts – Avoiding Serotonin Syndrome
22:40 Special Populations and Red Flags
26:00 Monitoring and Counseling Checklist
30:30 Wrap-Up – From What to Why to How