Psychopharmacology Made Simple: What’s it like when an SSRI[i] works?

Psychopharmacology Made Simple: What’s it like when an SSRI[1] works?

What benefit can one expect from a medication? While it’s easy enough to find information online about side effects and diagnostic indications (approved uses), it’s much more difficult to learn how it feels, from the patient’s point of view, when a medication works well.

Numerically, there are drops in rating scales, like the GAD-7 or the PHQ-9. [2] But it’s more useful (and certainly more interesting) to hear a patient’s experience directly.

This patient had started on Lexapro (escitalopram) [3] three months earlier. Her primary

complaint was her irritability, which led her to make harsh, critical comments to coworkers that she always regretted.

She returned 3 months later for a follow-up visit and noted she felt much less stressed.

“Things don’t bother me nearly as much; it’s like water off a duck’s back”. [4]For example, “previously my husband would say things I found very irritating and I would debate with him to try to change his mind. Now, I realize we don’t have to feel the same way about everything. I’m much better about letting things go.” “It’s much easier to talk with people and care about how they feel, because I care less about how I’m feeling, because I feel less upset about things. It’s amazing. Everything seems so much easier.”

Annoying things are still annoying, but the annoyance doesn’t last as long, it’s easier to put it aside, and the pain caused is not as great.

Is a medication worth taking? No one knows before trying a new one. One weighs the benefits and the side effects, and decides.




[1] SSRIs are selective serotonin reuptake inhibitors.

[2] The GAD-7 and PHQ-9 are commonly used patient rated scales that give the clinician a rough sense of the level of  anxiety and depression the patient is dealing with.

[3] Lexapro is a one of the 6 SSRIs (selective serotonin reuptake inhibitors, the others being, in rough order

of their release, fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), and

citalopram (Celexa)). It is approved for major depression and generalized anxiety disorder, and, like the

other members of its class, tends to work particularly well for anxiety, which often manifests in the form of

looping negative thoughts, and irritability.

[4] This is the most frequent simile patients use to describe their experience.

This entry was posted in First Comments. Bookmark the permalink.

Comments are closed.