Selective Serotonin Reuptake Inhibitors

Fluoxetine, Fluvoxamine, Escitalopram, Paroxetine and Sertraline belong to a group of antidepressants known as Selective Serotonin Reuptake Inhibitors (SSRIs).

​What is this medication used for

Fluoxetine, Fluvoxamine, Escitalopram, Paroxetine and Sertraline belong to a group of antidepressants known as Selective Serotonin Reuptake Inhibitors (SSRIs).

It is used to treat symptoms of low mood such as:

  • feelings of sadness
  • feelings of hopelessness or worthlessness
  • feeling bad about yourself
  • suicidal thoughts
  • poor sleep, energy or appetite

It may also be used to treat symptoms of anxiety such as:

  • very fast heartbeat
  • tremors (shaking of body parts e.g. hands)
  • sweating
  • nervousness ​

The medicine may also be used for obsessive-compulsive disorders, eating disorders, and other conditions – check with your doctor. 

​​​​Dosage and How to Use

Follow the directions on your medicine label and take the medicine exactly as directed, do not take more or less than prescribed.

It is recommended that you take the medicine with or after food. Sertraline should always be taken with food to improve its absorption by your body.

The medicine may not work for you straightaway. Continue to take it regularly. It may take a few weeks before you feel the full benefits of the medicine.

Even after you feel better, you should continue taking this medicine regularly to prevent your symptoms from returning. Do check with your doctor on the appropriate length of treatment you need.

Do not stop taking it or adjust the dose without talking to your doctor or pharmacist first. You may experience unpleasant effects if you suddenly stop taking the medicine.

Missed a Dose

Take the missed dose as soon as you remember it. However, if it is more than half way between the doses, skip the missed dose and take your medicine at the usual time. ​

Do not take two doses at the same time to make up for a missed one. ​​

If you have problems remembering your doses, speak to your pharmacist or doctor.


Side Effects, Precautions, Contraindication

Before using this medicine:

Tell your doctor if you have or have ever had bipolar disorder or mania (abnormally high or excited mood, or excessive activity and energy); heart, liver, or kidney disease; seizures (fits); diabetes; glaucoma; Parkinson’s disease; low sodium levels; bleeding problems; or if you have taken other antidepressants in the past 2 weeks.

FOR WOMEN: Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.

Possible Side Effects

Like all medicines, this medicine may also cause some POSSIBLE side effects but not everyone experiences them. ​

Common side effects​​​​​​ What can I do about it?​
​​​(Generally affect up to 10% of patients) 
Most of the side effects below improve as your body gets used to the medicine. Speak to your doctor or pharmacist if they persist, worsen or become too bothersome.
Nausea or vomiting; loss of appetiteTake the medicine with or after food.

Take small but frequent meals; avoid rich or spicy foods.​

​Diarrhoea​​​Drink plenty of water to replace loss of fluids.​
Dizziness​Get up slowly from sitting or lying down position.​​
Difficulty sleepingAvoid daytime naps.

Listen to relaxing music at bedtime​

​Tiredness; drowsiness​​Avoid driving, or engaging in activities requiring concentration.​
​Nervousness; trembling; increased sweating​​​​​​​​Nervousness usually occurs at the start of treatment and improves over time.
​Decreased sexual drive or ability​​​Speak with the doctor if any of these become bothersome.​


Check with your doctor as soon as possible if you experience any of the following:

~ Allergic reaction: Skin rash or itching; swelling in the face, eyes or tongue; chest tightness; difficulty breathing

~ Fever, confusion, severe weakness, uncontrolled movements or twitching of muscles

~ Feelings of intense agitation or anxiety, restlessness or inability to sit still

~ Talking, feeling, and acting with excitement that you cannot control

~ Seizures (fits)

If you experience any other side effects that you think are caused by your medicine, please consult your doctor or pharmacist.

Precautions while using this medicine:

  • Avoid drinking alcohol while taking this medicine as it can worsen symptoms of depression, increase anxiety, and cause excessive drowsiness.

  • Your mental condition may change in unexpected ways especially in the first few weeks of treatment and during dose changes. Contact your doctor immediately if you experience new or increasing thoughts of harming yourself, worsening anxiety, restlessness, violent behaviour, or other changes in mood and behaviour. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.

  • Taking some other medicines with this medicine may affect how they work. Be sure that you tell all doctors, pharmacists, dentists and other health care providers who treat you about all medicines and natural remedies you are taking.


Handling and Storage

Store this medicine at room temperature, away from direct light, heat and moisture (not in the bathroom) and out of reach of children. Throw away any medicine that has expired or is no longer needed.

Do not share the medicine with other people.

If you have questions/concerns about your medicine, ask your doctor or pharmacist.


Institute of Mental Health

Pharmacy Department​​
10 Buangkok View
Singapore 539747​

For medication enquiries: (during office hours)

IMH Clinic B/ Sayang Wellness: 63892077

IMH Clinic C (NAMS): 63893666

Community Wellness Clinic, Queenstown: 64715797

Community Wellness Clinic, Geylang: 67461724

Child Guidance Clinic (HPB): 64353807

Child Guidance Clinic (Sunrise Wing): 63892410


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