The Potential Impact of Selective Serotonin Reuptake Inhibitors on Delayed Onset Muscle Soreness: A Prospective...

Selective serotonin reuptake inhibitors (SSRIs) are widely prescribed for mood disorders. Their association with musculoskeletal side effects raises the question of potential SSRI impact on exercise-induced muscle damage and recovery.

The purpose of this prospective cohort study was to determine if SSRI use influences muscle function following a bout of eccentric exercise designed to induce delayed onset muscle soreness (DOMS).

Subjects between 18 and 30 years of age were recruited in a university setting. This included 1 group taking SSRIs prescribed by their health care provider, and a control group not using SSRIs. Subjects performed a DOMS induction protocol consisting of 300 eccentric knee extensions on an isokinetic dynamometer. Muscle soreness, thigh circumference, quadriceps flexibility, and isometric quadriceps strength were measured at baseline and at 24-, 48-, 72-, and 96-hour post-DOMS protocol. Comparisons were made between SSRI users and control subjects.

Thirty-six subjects included 18 SSRI users and 18 controls. The DOMS protocol induced muscle soreness in both groups (P < .001 when compared with baseline). At 72 hours a between-group difference was observed for thigh muscle flexibility (MD = 11.2, SE = 5.0, 95% CI [0.9, 21.4], P = .033, ηp² = .126) but no additional significant between-group differences in soreness, strength, thigh circumference, or flexibility were noted at any timepoint.

In this population, SSRI use had no effect on muscle soreness, circumference, or strength of the quadriceps following eccentric DOMS-inducing exercise. A difference in flexibility between SSRI and control groups at a single time point likely reflects a Type 1 error and is not likely of clinical consequence. These findings suggest SSRIs do not impair short-term recovery from exercise-induced muscle damage in healthy young adults, but potential SSRI impacts on longer-term training adaptations and recovery in athletic populations remain unknown.