Why are SSRIs so alike?
Except for clinically relevant differences in their pharmacokinetics and their effects on oxidative drug metabolism, all of the SSRIs are quite similar to each other (Table 1). That is why the differences in their pharmacokinetics and their effects on oxidative drug metabolism take on such importance when evaluating the relative merits of these drugs.1,2 If there were clinically meaningful differences in the neuropsychopharmacology of the various SSRIs, then the differences in their pharmacokinetics and effects on oxidative drug metabolism would be less pivotal as the defining difference among the members of this class. SSRIs have so much in common because each was developed with the intent of producing a molecule capable of selectively binding to and blocking the serotonin uptake pump. That goal was achieved, as can readily be seen in Figure 1, which shows the binding affinities of the five currently marketed SSRIs for a number of clinically important neural mechanisms of action. The
