Adverse Effects
General side effects are mostly present during the first 1–4 weeks while the body adapts to the drug (with the exception of sexual side effects, which tend to occur later in treatment). In fact, it often takes 6–8 weeks for the drug to begin reaching its full potential (the slow onset is considered a downside to treatment with SSRIs). Almost all SSRIs are known to cause one or more of these symptoms:
- nausea/vomiting
- drowsiness or somnolence
- headache (very common as a short-term side effect)
- bruxism
- extremely vivid or strange dreams
- dizziness
- mydriasis (pupil dilation)
- changes in appetite
- insomnia and/or changes in sleep
- excessive diarrhea
- weight loss/gain (measured by a change in bodyweight of 7 pounds)
- increased risk of bone fractures by 1.7 fold
- changes in sexual behaviour (see the next section)
- increased feelings of depression and anxiety (which may sometimes provoke panic attacks)
- mania
- tremors
- autonomic dysfunction including orthostatic hypotension, increased or reduced sweating
- akathisia
- suicidal ideation (thoughts of suicide)
- photosensitivity
- paresthesia
- cognitive disorders
- Syndrome of inappropriate antidiuretic hormone hypersecretion
Many side effects disappear after the adaptation phase, when the antidepressant effects begin to come to prominence. However, despite being called general, the side effects and their durations are highly individual and drug-specific. Usually the treatment is begun with a small dose to see how the patient's body reacts to the drug, after that either the dose can be adjusted (e.g. Prozac in the UK is begun at a 20 mg dose, and then adjusted as necessary to 40 mg or 60 mg). Should the drug prove ineffective, or the side effects intolerable to the patient, another common route is to switch treatment to either another SSRI, or an SNRI.
Mania or hypomania is a possible side effect. Users with some type of bipolar disorder are at a much higher risk, however SSRI-induced mania in patients previously diagnosed with unipolar depression can trigger a bipolar episode; however, according to DSM IV-TR, the diagnosis of bipolar disorder requires that the individuals symptoms must not stem from medication side effects, toxins, drug abuse, or another general medical condition.
Read more about this topic: Selective Serotonin Reuptake Inhibitor
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