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

Background: 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. Objective: 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). Methods: 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. Results: 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, ηp 2 = .126) but no additional significant between-group differences in soreness, strength, thigh circumference, or flexibility were noted at any timepoint. Conclusion and Relevance: 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.