Selective serotonin reuptake inhibitors (SSRIs) are among the most
widely prescribed medications, and they are remarkably safe and
effective. But no medical treatment is without risk. The May issue of
the Harvard Mental Health Letter reviews the potential side effects of these popular antidepressants and puts them into perspective.
Here are some of the side effects the Harvard Mental Health Letter describes:
symptoms. Some patients taking SSRIs develop insomnia, rashes,
headaches, joint and muscle pain, stomach upset, nausea, or diarrhea.
These problems are usually temporary, mild, or both.
problems. A more serious potential problem is reduced blood clotting
capacity that increases risk for stomach or uterine bleeding. If
patients use SSRIs and NSAIDs (aspirin, ibuprofen, naproxen, COX-2
inhibitors) at the same time, the risk more than doubles, so these
drugs must be combined with care.
effects. For many patients, SSRIs diminish sexual interest, desire,
performance, satisfaction, or all four. Lowering the dose, switching
antidepressants, or, for men, taking a drug like sildenafil (Viagra)
- Suicide. The risk that
antidepressants will incite violent or self-destructive actions has
become the subject of renewed controversy. One reason for concern is
the increasing number of children and adolescents receiving
prescriptions for antidepressants. When compared with a placebo, all
antidepressants, including SSRIs, seem to double the risk of suicidal
thinking, from 1%–2% to 2%–4%, in both children and adults.
follow-up and close monitoring are important. Also, patients should be
warned that there is a slight chance they will feel worse for a while,
and that they should let their prescribing clinicians know immediately
if they begin to feel worse or develop new symptoms, especially after
changing the medication or the dose.
Also in this issue:
- The homeless mentally ill
- How chronic stress may cause body cells to die
- A doctor answers: What does the amygdala do?