At Ruby Mental Wellness, we are excited to announce a new blog series designed to inform, empower, and engage our community in understanding mental health and psychiatry in a comprehensive and accessible way.
Here’s what you can expect:
🌍 Mondays: “Medication Mondays”
Every Monday, we’ll guide you through different classes of psychiatric medications. We will explore:
- How medications work (mechanisms of action)
- Side effects (common and rare, and how to mitigate them)
- What conditions they treat (both FDA-approved and off-label uses)
- Clinical pearls to provide real-world context for patients and families
🕖 Wednesdays: “Wellness Wednesdays”
Each Wednesday, we’ll discuss topics related to:
- Mental health symptoms and diagnoses
- Common misconceptions
- Clarifying complexities in mental health care
First up on “Medication Monday”: Antidepressants (SSRIs)
We’ll kick off the series with a deep dive into Selective Serotonin Reuptake Inhibitors (SSRIs):
Topic Details
How they work: SSRIs block the reuptake of serotonin (5-HT) in the brain, increasing serotonin availability in the synaptic cleft.
Debunking the “serotonin deficiency” myth: Depression is not simply due to “low serotonin”; the serotonin theory is overly simplistic. SSRIs affect mood indirectly and work through complex brain circuits.
Common side effects: Nausea, headache, sexual dysfunction, insomnia, GI upset, emotional blunting.
Onset of action: Typically 2-4 weeks for anxiety disorders; 4-6 weeks for major depression.
Conditions treated: Major depressive disorder, anxiety disorders (GAD, panic disorder, OCD, PTSD), PMDD, and off-label uses (e.g., bulimia nervosa).
Differences among SSRIs: Fluoxetine: activating, long half-life; Sertraline: GI upset common; Paroxetine: sedating, weight gain; Escitalopram: clean side effect profile.
Fun facts: Fluoxetine (Prozac) has the longest half-life and is self-tapering; Sertraline is preferred in pregnancy.
Mitigating side effects: Take with food, dose timing (e.g., AM vs PM), adjusting dose gradually, managing sexual side effects proactively.
We encourage patients to talk openly with us about sensitive topics — including sexual changes — early on. Not everyone experiences these side effects, but if they do, we can only help if we know about them!
Also, it’s important to know that some conditions, such as OCD, often require higher doses of SSRIs. This doesn’t mean a patient is “sicker” or “hard to treat” — it reflects how different disorders respond neurobiologically.
- Improvements often begin subtly: better sleep, increased energy, more engagement.
- Mood may improve gradually after physical symptoms ease.
- We look for signs of “windows of wellness” — moments when things feel more manageable — even before full recovery.
Instead, we want to ensure you are tolerating the medication and can adjust quickly if needed.
Mnemonic to remember SSRIs:
“Effective For Sadness, Panic, Compulsions”
- Escitalopram
- Fluoxetine
- Sertraline
- Paroxetine
- Citalopram
After SSRIs, we will cover SNRIs, atypical antidepressants, TCAs, MAOIs, and beyond. Once we complete antidepressants, we’ll move into anti-anxiety medications, mood stabilizers, stimulants, non-stimulants, sleep medications, supplements, nutrient deficiencies, and hormone therapy.
We look forward to helping you navigate these important topics every Monday and Wednesday. Stay tuned and join us on this educational journey toward better mental health care.
The Ruby Mental Wellness Team
