The first drug in the SSRI class was Prozac (Fluoxetine), which hit the United States market in 1987. Luvox (Fluvoxamine maleate) was the next SSRI FDA approved in December 05, 1994.However, now its marketing status is "Discontinued".The SSRIs represent the first rationally designed class of psychotropic medications.The strategy behind rational drug development is to design a new drug that is capable of affecting a specific neural site of action (eg, uptake pumps, receptors) while avoiding effects on other site of actions.Lexapro is not approved for use in pediatric patients less than 12 years of age.].A major depressive episode (DSM-IV) implies a prominent and relatively persistent (nearly every day for at least 2 weeks) depressed or dysphoric mood that usually interferes with daily functioning, and includes at least five of the following nine symptoms: depressed mood, loss of interest in usual activities, significant change in weight and/or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, a suicide attempt or suicidal ideation.
Families and caregivers should be advised of the need for close observation and communication with the prescriber.
Augmentation with lithium or triiodothyronine may be useful in patients who are partially or totally resistant to antidepressant treatment.
Finally, tapering anti-depressant medication may help to avoid discontinuation syndrome or antidepressant withdrawal.
Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older.
Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide.