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Adverse reactions to antidepressants

  • Rudolf Uher (a1), Anne Farmer (a1), Neven Henigsberg (a2), Marcella Rietschel (a3), Ole Mors (a4), Wolfgang Maier (a5), Dejan Kozel (a6), Joanna Hauser (a7), Daniel Souery (a8), Anna Placentino (a9), Jana Strohmaier (a3), Nader Perroud (a10), Astrid Zobel (a5), Aleksandra Rajewska-Rager (a7), Moica Z. Dernovsek (a11), Erik Roj Larsen (a12), Petra Kalember (a2), Caterina Giovannini (a9), Mara Barreto (a8), Peter McGuffin (a1) and Katherine J. Aitchison (a1)...
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.

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Copyright
Corresponding author
Rudolf Uher, P080 SGDP, Institute of Psychiatry, 16 De Crespigny Park, London SE5 8AF, UK. Email: r.uher@iop.kcl.ac.uk
Footnotes
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The GENDEP study was funded by a European Commission Framework 6 grant, EC Contract Ref.: LSHB-CT-2003-503428. Lundbeck provided both nortriptyline and escitalopram free of charge for the GENDEP study. GlaxoSmithKline and the Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King's College London and South London and Maudsley NHS Foundation Trust (funded by the National Institute for Health Research, Department of Health, UK) contributed by funding an add-on project in the London centre. The funders had no role in the design and conduct of the study, in data collection, analysis, interpretation or writing the report.

Declaration of interest

N.H. participated in clinical trials sponsored by pharmaceutical companies, including GlaxoSmithKline and Lundbeck. A.F., P.M. and K.J.A have received consultancy fees and honoraria for participating in expert panels from pharmaceutical companies, including Lundbeck and GlaxoSmithKline.

Footnotes
References
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Adverse reactions to antidepressants

  • Rudolf Uher (a1), Anne Farmer (a1), Neven Henigsberg (a2), Marcella Rietschel (a3), Ole Mors (a4), Wolfgang Maier (a5), Dejan Kozel (a6), Joanna Hauser (a7), Daniel Souery (a8), Anna Placentino (a9), Jana Strohmaier (a3), Nader Perroud (a10), Astrid Zobel (a5), Aleksandra Rajewska-Rager (a7), Moica Z. Dernovsek (a11), Erik Roj Larsen (a12), Petra Kalember (a2), Caterina Giovannini (a9), Mara Barreto (a8), Peter McGuffin (a1) and Katherine J. Aitchison (a1)...
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