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Nassir Ghaemi, MD, MPH, Explores SRIs at APA Annual Meeting
Dr Nassir Ghaemi explores the long-term effects and safety of serotonin reuptake inhibitors, revealing benefits and potential risks.
CONFERENCE REPORTER
The serotonin reuptake inhibitors (SRIs) have been heralded and demonized in the popular press in books like Listening to Prozac, Prozac Nation, and Let Them Eat Prozac, but “both extremes are right and wrong, for different reasons,” Nassir Ghaemi, MD, MPH, told Psychiatric Times in an interview following his session at the 2025 American Psychiatric Association Annual Meeting in Los Angeles, California.1
The SRIs revolutionized modern psychiatry in the 1990s, Ghaemi said, and he has witnessed their rise to popularity and overall impact on the field. His session focused on reviewing the efficacy and safety of the agents for the various psychiatric conditions that they are prescribed for. In reviewing both short- and long-term studies, he discussed that the evidence points to the most benefit in acute depression symptoms as opposed to long-term disease modification. He also reviewed the evidence for anxiety and obsessive compulsive disorder.
“There is a lot of nuance to be considered,” Ghaemi reported.” Consider serotonin withdrawal syndrome. How good are the data that guides us? What does it look like? How is it to be distinguished from treatment response? Do we have any idea how frequent it is? What can one do about it? Potential carcinogenicity is a topic that is difficult to study but inappropriate to ignore. What is the evidence for and against such risk? Even sexual side effects, their presence and frequency is far from a mystery. But can it be addressed? How does it interact with other phase of life shifts in sexual interest/capacity - such as adolescence and menopause? Suicidality is controversial.”
Ghaemi has long been a proponent of the adage, half of what you see is false; you just don’t know which half. With that in mind, he has challenged the status quo to encourage critical analysis regarding many of the tenets in psychiatry, as elucidated in an interview with Conversations in Critical Psychiatry founder Awais Aftab, MD.2
References
1. Ghaemi N. Serotonin reuptake inhibitors through the life span: past and present. Presented at the 2025 American Psychiatric Association Annual Meeting; May 17-21l, 2025; Los Angeles.
2. Aftab A. Conversations in critical psychiatry: The rise and fall of pragmatism in psychiatry. Psychiatric Times. 2019; 36(12):32-33.
