Why are selective serotonin reuptake inhibitors (SSRIs) so popular?

Is it simply easier/safer to prescribe an SSRI than any other type of treatment?
Are most cases of depression caused by a serotonin problem?

When SSRIs came out on the market at the beginning of the 90s, big pharma marketed them as the new wonder pills with almost no side effects, but today we know that they cause substantial sexual side effects, gastrointestinal side effects, dizziness, sleep disturbances (insomnia, sleepiness), headaches, agitation & tremor / shaking...

I don't want to even start on zombification, lack of emotions, apathy and so on...

And what about Citalopram/Escitalopram-induced QTc prolongation? Wasn't that always an anti-TCA argument? "Bad TCAs may cause problems with your heart, but SSRIs don't!"

And for all we know right now, SSRIs don't show greater efficacy than TCAs, TeCAs, MAOIs, Atypicals etc.
I will not deny that there are people out there, who benefit from SSRIs, but that's also true for TCAs, TeCAs, MAOIs, Atypicals...

So what's the big deal with SSRIs?
Why are they randomly prescribed like children's candy?

Hi, DuckBruck, and welcome to Psych Central! Maybe Big Pharma "sells" them to doctors more and potential takers see the ads? I have heard, though, that ECT is often the first line of treatment for depression in some places, but I don't know if that's true. I think Serotonin is an "up" brain neurotransmitter. It makes people feel better.

Are more people depressed these days? I don't know what percentage of the adult population takes them as opposed to other treatments.

My stab at an answer, anyway.

Again, welcome!

(I have bipolar disorder and have taken SSRIs over the years. As you would predict, I have never been asked about other treatments by my doctors.)

They are expensive placebos with serious side effects. It's the side effects that make people think they are working when what they are really doing is shutting down the bodies ability to produce its own serotonin.

Thank you

Possibly. When they were all on patent so maximum profits could be made.

Most doctors don't take the condition of the patient into account.
For example, if there is a depressive patient, underweight, with insomnia, agitation and with gastrointestinal problems, then prescribing him an SSRI like Sertraline or something like Bupropion (Wellbutrin) will probably make him feel worse. Better would be Mirtazapine, Maprotiline or an classical TCA. Or even a combo, for example Sertraline + Mirtazapine. But no, let's play the SSRI carousel...

SSRI's are widely prescribed for a number of reasons, but let's face it: they help many, many people. They have far fewer side-effects than the old antidepressants do (most people under 50 won't have had experience with the old a-d's, lucky for them).

There's nobody on earth gonna tell me that SSRI's and SSNI's are placebos. They have helped me to have a functional life.