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Antidepressant Adverse Effects
Aka: Antidepressant Adverse Effects
- See Also
- Antidepressant
- Serotonin Syndrome
- Antidepressant Withdrawal
- Adverse Effects: Least Tolerated Agents (early discontinuation)
- Most: Tricyclic Antidepressants, SNRI
- Least: SSRI, Bupropion
- Adverse Effects: Anticholinergic Symptoms
- Most: Tricyclic Antidepressants (Tertiary amines)
- Least: SSRI, Bupropion, SARI, MAO inhibitors
- Adverse Effects: Weight gain (Histamine H1 receptor blockade)
- Most: Tricyclic Antidepressants, Remeron, Paxil
- Least: Bupropion, Prozac
- Adverse Effects: Orthostatic Hypotension (alpha 1 receptor blockade)
- Most: Tricyclic Antidepressants (Tertiary amines)
- Least: Bupropion, SSRI
- Adverse Effects: Bleeding Risk (Drug Interaction)
- SSRI and SNRI agents increase risk of bleeding events when combined with Anticoagulants and antiplatelet agents
- Drug Interactions occur primarily with Warfarin
- One additional patient on Warfarin for Atrial Fibrillation with SNRI or SSRI will have have a major bleeding event
- However, also affect other Anticoagulants such as Pradaxa and antiplatelet agents
- Most: Fluoxetine, Flovoxamine (especially with Warfarin)
- Least: Mirtazapine, Bupropion
- References
- (2014) Presc Lett 21(11): 65
- Sansone (2009) Psychiatry 6(7): 24–29 [PubMed]
- Adverse Effects: Cardiac Arrhythmia (Type 1A Antiarrhythmic effect)
- Most: Tricyclic Antidepressants (Tertiary amines)
- Least: Bupropion, SSRI
- Although QT Prolongation has been seen with Citalopram and Escitalopram
- Adverse Effects: Gastrointestinal effects (Serotonin reuptake blockade)
- Most adverse effects
- Nausea or Vomiting: Effexor
- Constipation: Paxil
- Diarrhea: Zoloft
- Minimal: Prozac, MAO inhibitors, Trazodone
- None: Tricyclic Antidepressants, Bupropion
- Adverse Effects: Sedation (Histamine H1 receptor blockade)
- Most: Tricyclic Antidepressants, Serzone, Trazodone
- Moderate: Remeron, Paxil, Nardil
- None: Bupropion, Effexor, Prozac
- Adverse Effects: Agitation or Insomnia
- Most: Bupropion, Prozac, Sertraline
- Least: Tricyclic Antidepressants, Effexor, Trazodone, Paxil
- Adverse Effects: Increased Seizure risk (Lower Seizure threshold)
- Most: Bupropion, Anafranil, Tricyclic Antidepressant
- Least: SSRI, MAO inhibitor, SARI, Effexor
- Adverse Effects: Sexual Dysfunction (Serotonin reuptake blockade)
- See Antidepressant Induced Sexual Dysfunction
- Most: SSRI (esp. Paroxetine, Escitalopram), Tricyclic Antidepressants, MAO inhibitor
- Least: Bupropion, Nefazodone
- Adverse Effects: Miscellaneous
- Hyponatremia
- Selective Serotonin Reuptake Inhibitors or SSRI (OR 3.3)
- References
- Bhatia (1997) Am Fam Physician 55(5):1683-94 [PubMed]
- Hansen (2005) Ann Intern Med 143:415-26 [PubMed]
- Kovich (2015) Am Fam Physician 92(2): 94-100 [PubMed]