Adverse reactions to antidepressants.
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.


OBJECTIVE
To evaluate a simple self-report measure and describe adverse reactions to antidepressants in a large sample.


METHODS
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.
Uher
Rudolf
R
P080 SGDP, Institute of Psychiatry, King's College London, London SE5 8AF, UK. r.uher@iop.kcl.ac.uk
Farmer
Anne
A
Henigsberg
Neven
N
Rietschel
Marcella
M
Mors
Ole
O
Maier
Wolfgang
W
Kozel
Dejan
D
Hauser
Joanna
J
Souery
Daniel
D
Placentino
Anna
A
Strohmaier
Jana
J
Perroud
Nader
N
Zobel
Astrid
A
Rajewska-Rager
Aleksandra
A
Dernovsek
Moica Z
MZ
Larsen
Erik Roj
ER
Kalember
Petra
P
Giovannini
Caterina
C
Barreto
Mara
M
McGuffin
Peter
P
Aitchison
Katherine J
KJ
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects*; D015283:Citalopram / Q000009:adverse effects*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009661:Nortriptyline / Q000009:adverse effects*; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013223:Statistics as Topic; D011795:Surveys and Questionnaires / Q000592:standards*; D013997:Time Factors; D016055:Urinary Retention / Q000139:chemically induced; D014987:Xerostomia / Q000139:chemically induced; D055815:Young Adult
D000928:Antidepressive Agents; D015283:Citalopram; D009661:Nortriptyline