Adverse reactions to antidepressants.

Abstract

BACKGROUND:

Adverse drug reactions are important determinants of non-adherence to antidepressant treatment, but their assessment is complicated by overlap with depressive symptoms and lack of reliable self-report measures.

AIMS:

To evaluate a simple self-report measure and describe adverse reactions to antidepressants in a large sample.

METHOD:

The newly developed self-report Antidepressant Side-Effect Checklist and the psychiatrist-rated UKU Side Effect Rating Scale were repeatedly administered to 811 adult participants with depression in a part-randomised multicentre open-label study comparing escitalopram and nortriptyline.

RESULTS:

There was good agreement between self-report and psychiatrists' ratings. Most complaints listed as adverse reactions in people with depression were more common when they were medication-free rather than during their treatment with antidepressants. Dry mouth (74%), constipation (33%) and weight gain (15%) were associated with nortriptyline treatment. Diarrhoea (9%), insomnia (36%) and yawning (16%) were more common during treatment with escitalopram. Problems with urination and drowsiness predicted discontinuation of nortriptyline. Diarrhoea and decreased appetite predicted discontinuation of escitalopram.

CONCLUSIONS:

Adverse reactions to antidepressants can be reliably assessed by self-report. Attention to specific adverse reactions may improve adherence to antidepressant treatment.

• Authors: Rudolf Uher, Anne Farmer, Neven Henigsberg, Marcella Rietschel, Ole Mors, Wolfgang Maier, Dejan Kozel, Joanna Hauser, Daniel Souery, Anna Placentino, Jana Strohmaier, Nader Perroud, Astrid Zobel, Aleksandra Rajewska-Rager, Moica Z Dernovsek, Erik Roj Larsen, Petra Kalember, Caterina Giovannini, Mara Barreto, Peter McGuffin, Katherine J Aitchison
• Journal: The British journal of psychiatry : the journal of mental science (Br J Psychiatry) Vol. 195 Issue 3 Pg. 202-10 (Sep 2009) ISSN: 1472-1465 [Electronic] England
• PMID: 19721108 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antidepressive Agents
• Citalopram
• Nortriptyline

Topics

• Adult
• Aged
• Antidepressive Agents (adverse effects)
• Citalopram (adverse effects)
• Depressive Disorder (drug therapy, psychology)
• Female
• Humans
• Male
• Middle Aged
• Nortriptyline (adverse effects)
• Patient Acceptance of Health Care (psychology, statistics & numerical data)
• Psychiatric Status Rating Scales
• Severity of Illness Index
• Statistics as Topic
• Surveys and Questionnaires (standards)
• Time Factors
• Urinary Retention (chemically induced)
• Xerostomia (chemically induced)
• Young Adult