PsychRounds: The Psychiatry Podcast

SSRIs Revisited: The 100th Episode

10 snips
Nov 5, 2025
The hosts celebrate a milestone while revisiting SSRIs, diving into their historical roots and the evolution of antidepressants. They explore the limitations of the serotonin theory and discuss SSRIs' broader impacts on the gut and neuroplasticity. Adverse effects, such as sexual dysfunction and weight changes, are highlighted, along with concerns about youth suicidality and cautious use in bipolar disorder. The conversation wraps up with reflections on SSRIs' role in modern psychiatry and the implications of overprescription.
Ask episode
AI Snips
Chapters
Books
Transcript
Episode notes
ANECDOTE

Early Mentors And A Skeptical Co-Host

  • Larry Wang thanked Dr. Lori Garces for early mentorship and feedback on their SSRI episode.
  • Bradley Miller admitted he was initially skeptical about the podcast but later joined and appreciated the project.
INSIGHT

History Shows Treatment, Not Proof Of Cause

  • Early antidepressants like MAOIs and TCAs revealed monoamine modulation as a treatment lever, not a definitive cause of depression.
  • The 'chemical imbalance' idea is overstated, yet monoamine-targeting drugs can still provide clinical benefit.
INSIGHT

Why SSRIs Take Weeks To Work

  • Rising monoamines after SSRI dosing occurs quickly but mood improvement lags by weeks due to downstream adaptations.
  • Desensitization of presynaptic autoreceptors and downstream neuroplastic changes likely explain the delay.
Get the Snipd Podcast app to discover more snips from this episode
Get the app