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