I think I am relapsing and will have to take my pills forever. Maria is experiencing discontinuation symptoms. Gradual tapering of venlafaxine, taking These disappear after another week. Apart from the annoying and bothersome adverse effects described above, the clinician should be aware of several serious adverse effects that can be associated with modern antidepressants.
Even after short-term use of an SSRI or venlafaxine, the risk of upper GI bleeding is slightly higher than with the older TCAs, especially in higher-risk situations such as alcohol use.
Although depression is associated with the metabolic syndrome and some antidepressants may induce weight gain, there may not necessarily be a correlation between the two.
However, in young adults, long-term antidepressant use may increase the risk of type 2 diabetes mellitus. Although more often associated with TCAs, cardiovascular adverse effects, seizures, and agranulocytosis are also possible adverse effects of other antidepressants. Treatment decisions based on identifying risk factors, carefully reviewing all appropriate antidepressants, and patient preferences, as well as careful monitoring, will help keep adverse effects to a minimum Table.
Clinicians will be confronted with bothersome and sometimes severe adverse effects in their patients when prescribing antidepressants. Before the initiation of antidepressant treatment, patients should be informed about potential adverse effects and encouraged to contact the physician with any concerns, so that these can be managed adequately.
As a rule, begin with an antidepressant that has shown better tolerance at the lowest dose, then titrate slowly. Careful monitoring should focus on tolerance as well as on symptom alleviation. It is important to distinguish adverse effects from depression symptoms, such as fatigue and carbohydrate craving.
Should bothersome adverse effects emerge, watchful waiting is often a reasonable option, since most adverse effects diminish over time. Either reducing the dose or adjusting the dosing schedule can be tried before switching to another antidepressant.
If this strategy is not successful, the off-label addition of other pharmacological agents can be considered. Psychol Med. Compliance with antidepressants in a primary care setting, 1: beyond lack of efficacy and adverse events. J Clin Psychiatry. Incidence and duration of side effects and those rated as bothersome with selective serotonin reuptake inhibitor treatment for depression: patient report versus physician estimate.
Br J Psychiatry. Toward achieving optimal response: understanding and managing antidepressant side effects. You and your family members, caregivers, and healthcare provider should watch for any new or sudden changes in your mood, behaviors, thoughts, or feelings. Call your healthcare provider right away if you notice any changes. There are many types of antidepressants. Each comes with its own list of potential side effects. Before starting any new medication, let your healthcare provider know about any other medications you take, including over-the-counter drugs and herbal supplements, such as St.
If you drink alcohol, make sure to also ask about any potential interactions it might have with your medication. In addition to side effects, antidepressants can also cause allergic reactions in some people. Seek immediate medical treatment if you notice any symptoms of a severe allergic reaction, such as difficulty breathing or swelling in your face, tongue, or throat. Sexual side effects, like erectile dysfunction, are common complaints of taking antidepressants.
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Preskorn SH. Journal of Psychiatric Practice. Krieger CA expert opinion. Mayo Clinic. Hall-Flavin DK expert opinion.
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The side effects of selective serotonin reuptake inhibitors SSRIs can be troublesome at first, but most improve with time. In general, SSRIs are better tolerated than most other types of antidepressants. The majority of people will only experience a few mild side effects when taking them.
It's important to persist with treatment, even if you're affected by side effects, as it will take several weeks before you begin to benefit from treatment. With time, you should find that the benefits of treatment outweigh problems related to side effects. You'll usually see your doctor every few weeks when you first start taking SSRIs to discuss how well the medication is working. However, you can contact your doctor at any point if you experience any particularly troublesome or persistent side effects.
For information about the side effects of a particular SSRI, check the information leaflet that comes with your medication. These side effects should improve over time, although some — such as sexual problems — can persist.
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