Incidence and duration of side effects and those rated as bothersome with selective serotonin reuptake inhibitor treatment for depression: patient report versus physician estimate.
BACKGROUND
Selective serotonin reuptake inhibitors (SSRIs) are widely used as the first-line treatment for depression. Information regarding their side effects is mostly based on controlled clinical trials.


METHODS
Patients who received an SSRI for a new or recurrent case of depression (ICD-9 code 296.2 or 311) between December 15, 1999, and May 31, 2000 were interviewed by telephone 75 to 105 days after initiation of SSRI therapy. Using closed-ended questions, investigators asked patients if they experienced any of 17 side effects commonly associated with SSRIs, how bothersome they were, and what their duration was. Prescribing physicians completed a written survey providing their estimates about frequency of side effects associated with SSRIs and how bothersome those side effects are.


RESULTS
Of 401 patients who completed the phone interview, 344 patients (86%) reported at least 1 side effect, and 219 patients (55%) experienced 1 or more bothersome side effect(s). The most common bothersome side effects were sexual dysfunction and drowsiness (17% each). While most side effects first occurred within the first 2 weeks of treatment, the majority of patients were still experiencing the same side effects at the time of interview, most notably blurred vision (85%) and sexual dysfunction (83%). Overall, physicians (N = 137) significantly underestimated the occurrence of the 17 side effects explored, and they tended to underrate how bothersome those side effects were to their patients.


CONCLUSIONS
Side effects associated with SSRIs are common and bothersome to patients. Treatment-emergent side effects tend to persist during the first 3 months of treatment.
Hu
X Henry
XH
Outcomes Research & Management, Merck & Co., Inc., West Point, PA 19486, USA. Henry_Hu@Merck.com
Bull
Scott A
SA
Hunkeler
Enid M
EM
Ming
Eileen
E
Lee
Janelle Y
JY
Fireman
Bruce
B
Markson
Leona E
LE
D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D012894:Sleep Stages / Q000187:drug effects; D013997:Time Factors; D014786:Vision Disorders / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology; D014987:Xerostomia / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology
D017367:Selective Serotonin Reuptake Inhibitors