SELECTIVE SEROTONIN REUPTAKE INHIBITORS: AN INTEGRATED CLINICAL APPROACH IN THE MANAGEMENT OF ASTHMA AND DEPRESSION

Abstract

Asthma is a chronic inflammatory disease of the airways, characterized by recurrent airflow obstruction. Asthmatic patients have a higher prevalence of depression, a condition associated with poorer disease control, more frequent exacerbations, and increased morbidity. The coexistence of these conditions shares pathophysiological mechanisms, such as serotonin dysregulation, involved in both mood modulation and airway inflammatory processes. In this context, selective serotonin reuptake inhibitors (SSRIs) emerge as a possible therapeutic strategy with a potential positive impact on respiratory and psychological components, in addition to contributing to improved quality of life for patients. Objective: To highlight the role of Selective Serotonin Reuptake Inhibitors (SSRIs) in the integrated clinical approach to patients with asthma and depression. Method: This is an integrative literature review, conducted in the second half of 2025, based on the following guiding question: "What is the impact of SSRI use on the integrated clinical management of patients with asthma and depression?" This study was conducted using the online databases “Portal Regional da BVS” and “LILACS”, using the health sciences descriptors “asthma, depression, and selective serotonin reuptake inhibitors” registered in (DeCS). Studies published between 2020 and 2025 in English, Portuguese, and Spanish were included. Incomplete texts, literature reviews, and dissertations were excluded. Results: The analyzed studies demonstrated that depression directly impacts asthma control, being associated with greater clinical instability and poorer quality of life. The participation of the serotonergic system in the pathophysiological intersection between the conditions was evidenced, as well as the anti-inflammatory effects of SSRIs on the Th2 response and pro-inflammatory cytokines. Final considerations: Depression is associated with poorer asthma control, with a higher frequency of exacerbations and a negative impact on quality of life. The interaction between the two, mediated by the serotonergic system, points to SSRIs as potential adjuvants in the inflammatory control of asthma. The importance of systematic screening for depression in these patients and an integrated clinical approach is highlighted.