Adverse reactions to antidepressants

• Published in: British journal of psychiatry 2009-09, Vol.195 (3), p.202-210
• Main Authors: Uher, Rudolf, Farmer, Anne, Henigsberg, Neven, Rietschel, Marcella, Mors, Ole, Maier, Wolfgang, Kozel, Dejan, Hauser, Joanna, Souery, Daniel, Placentino, Anna, Strohmaier, Jana, Perroud, Nader, Zobel, Astrid, Rajewska-Rager, Aleksandra, Dernovsek, Moica Z., Larsen, Erik Roj, Kalember, Petra, Giovannini, Caterina, Barreto, Mara, McGuffin, Peter, Aitchison, Katherine J.
• Format: Article
• Language: English
• Subjects: Adherence; Adult; Adverse; Aged; Antidepressant drugs; Antidepressants; Antidepressive Agents - adverse effects; Citalopram; Citalopram - adverse effects; Complaints; Constipation; Critical incidents; Depression; Depressive Disorder - drug therapy; Depressive Disorder - psychology; Diarrhea; Discontinued; Drowsiness; Female; Humans; Insomnia; Male; Mental depression; Middle Aged; Mouth; Nortriptyline - adverse effects; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Psychiatric Status Rating Scales; Psychiatrists; Psychiatry; Self report; Selfreport; Severity of Illness Index; Side effects; Sleep disorders; Sleepiness; Statistics as Topic; Surveys and Questionnaires - standards; Time Factors; Urinary Retention - chemically induced; Urination; Xerostomia - chemically induced; Yawning; Yawning behavior; Young Adult
• ISSN: 0007-1250; 1472-1465
• DOI: 10.1192/bjp.bp.108.061960

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. To evaluate a simple self-report measure and describe adverse reactions to antidepressants in a large sample. 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. 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. Adverse reactions to antidepressants can be reliably assessed by self-report. Attention to specific adverse reactions may improve adherence to antidepressant treatment.