title: Physician perception regarding side-effect profile at the onset of antidepressant treatment: a survey of Israeli psychiatrists and primary care physicians.
abstract: BACKGROUND
  One of the major factors affecting treatment compliance and outcome in patients is the wide range of side effects (SEs) associated with antidepressants. In the present study, we aimed to assess the extent to which Israeli primary care (PC) physicians and psychiatrists discuss the SEs of selective serotonin reuptake inhibitors (SSRIs) with patients prior to the onset of treatment.
  
  
  METHODS
  A cross-sectional questionnaire survey was conducted among PC physicians (N = 123) and psychiatrists (N = 105). Questionnaires were distributed using a mixed-modality design, combining a web survey and in-person delivery of questionnaires.
  
  
  RESULTS
  A significant percentage of our respondents reported that they rarely discuss psychological (60 %) or severe (29 %) SEs of SSRIs. Nearly half (41 %) admitted to avoiding discussion of impact on suicidal ideation. Specialists were noted to discuss and evaluate SEs significantly more than residents, and Psychiatrists more than PC physicians. Specifically, psychiatrists more often discussed the possibility of sexual dysfunction (t (225) = 2.23; p < 0.05) and suicidal ideation (t (225) = 2.11; p < 0.05).
  
  
  CONCLUSIONS
  It seems that PC physicians and psychiatrists surveyed in this study do not share sufficient information regarding the SEs of SSRIs with their patients at the onset of treatment. In improving this practice, the integration of proper SE management into educational interventions has potential in enhancing compliance and improving expertise and level of care.
authors.affiliation: Shalvata Mental Health Care Center, 13 Aliyat Hanoar St, 45100 Hod-Hasharon, Israel ; Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
authors.forename: Uri
authors.initials: U
authors.lastname: Nitzan
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
authors.forename: Tal
authors.initials: T
authors.lastname: Bekerman
authors.affiliation: Shalvata Mental Health Care Center, 13 Aliyat Hanoar St, 45100 Hod-Hasharon, Israel.
authors.forename: Gideon
authors.initials: G
authors.lastname: Becker
authors.affiliation: Herzog Hospital, Givat Shaul, Jerusalem, Israel ; Faculty of Medicine, Hebrew University, Jerusalem, Israel.
authors.forename: Pesach
authors.initials: P
authors.lastname: Lichtenberg
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel ; Addiction Medicine Services, Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Tel Aviv, Israel.
authors.forename: Shaul
authors.initials: S
authors.lastname: Lev-Ran
authors.affiliation: Discipline of Psychiatry, University of Sydney, Sydney, NSW Australia ; Northern Sydney Local Health District, Sydney, Australia.
authors.forename: Garry
authors.initials: G
authors.lastname: Walter
authors.affiliation: Shalvata Mental Health Care Center, 13 Aliyat Hanoar St, 45100 Hod-Hasharon, Israel ; Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
authors.forename: Hagai
authors.initials: H
authors.lastname: Maoz
authors.affiliation: Shalvata Mental Health Care Center, 13 Aliyat Hanoar St, 45100 Hod-Hasharon, Israel ; Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
authors.forename: Yuval
authors.initials: Y
authors.lastname: Bloch
keywords: Adherence; Antidepressants; Compliance; SSRIs; Side effects
references.citation: Clin Ther. 2002 Feb;24(2):237-48
references.pmid: 11911554
references.citation: Int J Risk Saf Med. 2011;23(2):125-32
references.pmid: 21673422
references.citation: Can Fam Physician. 2003 Apr;49:489-91
references.pmid: 12729245
references.citation: JAMA. 2002 Dec 11;288(22):2836-45
references.pmid: 12472325
references.citation: Ann Pharmacother. 2009 Apr;43(4):642-9
references.pmid: 19318603
references.citation: Psychiatr Serv. 2006 Nov;57(11):1636-9
references.pmid: 17085613
references.citation: Psychiatry (Edgmont). 2009 Feb;6(2):16-8
references.pmid: 19724743
references.citation: Gen Hosp Psychiatry. 1993 Nov;15(6):399-408
references.pmid: 8112564
references.citation: Br J Psychiatry. 2005 Mar;186:177-8
references.pmid: 15738494
references.citation: Clin Ther. 2012 Jan;34(1):113-23
references.pmid: 22177545
references.citation: Ann Clin Psychiatry. 2004 Jan-Mar;16(1):15-25
references.pmid: 15147109
references.citation: Br J Clin Pharmacol. 1984 Jan;17(1):21-5
references.pmid: 6691885
references.citation: J Clin Psychiatry. 2012;73 Suppl 1:5-9
references.pmid: 22951236
references.citation: Med Care. 1995 Jan;33(1):67-74
references.pmid: 7823648
references.citation: CNS Spectr. 2007 Aug;12(8 Suppl 13):1-27
references.pmid: 17986951
references.citation: Ann Fam Med. 2005 Jan-Feb;3(1):23-30
references.pmid: 15671187
references.citation: Patient Educ Couns. 2004 Nov;55(2):241-6
references.pmid: 15530761
references.citation: Int Clin Psychopharmacol. 2008 Mar;23(2):106-9
references.pmid: 18301125
references.citation: J Clin Psychiatry. 2010;71 Suppl E1:e03
references.pmid: 20371030
references.citation: Int Clin Psychopharmacol. 2002 Nov;17(6):265-71
references.pmid: 12409679