Antidepressant - Adverse Effects

Adverse Effects

Antidepressants often cause adverse effects, and difficulty tolerating these is the most common reason for discontinuation.

SSRI side effects include but are not limited to: nausea, diarrhea, agitation, headaches anxiety, nervousness, emotional lability, increased suicidal ideation,suicide attempts, insomnia, serotonin syndrome, drug interactions, neonate adverse reactions, anorexia, dry mouth, somnolence, tremors, decreased libido, asthenia, dyspepsia, dizziness, sweating, personality disorder, epistaxis, urinary frequency, menorrhagia, mania/hypomania, chills, palpitations, taste perversion, and micturition disorder .

Sexual side-effects are also common with SSRIs, such as loss of sexual drive, failure to reach orgasm and erectile dysfunction. Serotonin syndrome is also a worrying condition associated with the use of SSRIs. The Food and Drug Administration requires Black Box warnings on all SSRIs, which state that they double suicidal rates (from 2 in 1,000 to 4 in 1,000) in children and adolescents, although it's controversial whether this is due to the medication or as part of the depression itself (i.e. efficacious antidepressant effect can cause those that are severely depressed, to the point of severe psychomotor inhibition, are rendered more alert and thus have increased capacity to carry out suicide even though they are relatively improved in state). The increased risk for suicidality and suicidal behaviour among adults under 25 approaches that seen in children and adolescents.

Moclobemide may be preferred in the elderly as its pharmacokinetics are not affected by age, is well tolerated by the elderly as well as younger adults, has few serious adverse events, and, in addition, it is as effective as other antidepressants that have more side-effects; moclobemide also has beneficial effects on cognition.

Side-effects of TCAs (tricyclic antidepressants): Fairly common side-effects include dry mouth, blurred vision, drowsiness, dizziness, tremors, sexual problems, skin rash, and weight gain or loss.

Side-effects of MAOIs (monoamine oxidase inhibitors): Rare side-effects of MAOIs like phenelzine (Nardil) and tranylcypromine (Parnate) include hepatitis, heart attack, stroke, and seizures. Serotonin syndrome is a side-effect of MAOIs when combined with certain medications.