Side effects of antidepressants: An overview CURRENT DRUG THERAPY

In elderly patients, serotonin reuptake inhibitors seem to be safer and better tolerated than tricyclic antidepressants. The choice should be made on the basis of side effect profile and drug interactions. URRENT ANTIDEPRESSANT DRUGS are effective and generally well tolerated, but noncompliance remains worrisome. Up to 70% of patients taking antidepressants are noncompliant,1,2 as a result of either missed doses or premature discontinuation. According to Lin et al,1 28% of patients stopped taking antidepressants in the first month of treatment, and 44% discontinued by the third month. Several reasons were identified for premature discontinuation, with side effects the most common. Dropout rates in studies of tricyclic antidepressants varied from 7% to 44%; in studies of serotonin reuptake inhibitors, the dropout rates were 7% to 23%.3,4 Physicians should educate and reassure their patients about potential side effects. Benign and transient side effects are more common than dangerous or irreversible effects, especially with the newer antidepressants. This knowledge can help in reducing the rate of medication discontinuation, which is important because even after a medication has produced the desired benefit, it needs to be continued to prevent relapses. This article will focus on the adverse effects of antidepressants, with the goal of helping physicians to recognize and understand them, so that patients can undergo effective treatment.