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SSRIs are the most widely used class of psychiatric medications, helpful for depression, anxiety, OCD, panic, PTSD, anger, and certain personality disorders (Why should the same drug treat all these things? Great question!) They\u2019ve been pretty thoroughly studied, but there\u2019s still a lot we don\u2019t understand about them.

The SSC Survey is less rigorous than most existing studies, but its many questions and very high sample size provide a different tool to investigate some of these issues. I asked fifteen questions about SSRIs on the most recent survey and received answers from 2,090 people who had been on SSRIs. The sample included people on all six major SSRIs, but there were too few people on fluvoxamine (15) to have reliable results, so it was not included in most comparisons. Here\u2019s what we found:

1. Do SSRIs work?

People seem to think so:

Made me feel much worse: 6%
Made me feel slightly worse: 7.4%
No net change in how I felt: 23.7%
Made me feel slightly better: 41.4%
Made me feel much better: 21.4%

Of course, these statistics include the placebo effect and so cannot be taken entirely at face value.

2. Do some SSRIs work better than others?

I asked people to rate their experience with the medication, on a scale from 1 to 10. Here were the results:

Lexapro (356): 5.7
Zoloft (470): 5.6
Prozac (339): 5.5
Celexa (233): 5.4
Paxil (126): 4.6

Paxil differed significantly from the others; the others did not differ significantly among themselves. In a second question where participants were just asked to rate their SSRIs from -2 (\u201cmade me feel much worse\u201d) to +2 (\u201cmade me feel much better\u201d), the ranking was preserved, and Lexapro also separated from Celexa.

This ranking correlates at r = 0.98 (!?!) with my previous study of this\xa0taken from drugs.com ratings.

I don\u2019t generally hear that Paxil is less effective than other SSRIs, but I have heard that it causes worse side effects. The survey question (probably wrongly) encouraged people to rate side effects as \u201cnegative efficacy\u201d. My guess is that the difference here is mostly driven by side effects.