Treatment-Emergent Adverse Events from Selective Serotonin Reuptake Inhibitors by Age Group: Children versus Adolescents

Background: Adverse drug reactions (ADRs) are considered among the leading causes of morbidity and mortality. 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 The present study was therefore undertaken to monitor the ADRs of the antidepressant in the psychiatric outpatient unit of Raichur Institute of Medical Sciences, Raichur, Karnataka, IndiaMethods: Study was conducted from December 2012 to November 2013, the patients on antidepressant drugs from psychiatry out- patient department (OPD) of Raichur Institute of Medical Sciences were considered for analysis. The patients were diagnosed by consultant psychiatrist. Data was collected in standard questionnaire format. All patients diagnosed with psychiatric disorder as per ICD 10 criteria and receiving treatment with antidepressant were included. Assessment of causality and severity of recorded adverse events was done using WHO assessment scale and modified Siegel and Hartwig Scale respectively.Results: In our study 74 adverse drug reactions(ADRs) were seen among 52 cases, total 263 cases were screened.CNS and Anticholinergic side effects were most common adverse drug reactions noted. Tricyclic antidepressants (TCA) and Selective serotonin reuptake inhibitors (SSRIs) were the drugs causing maximum ADRs. Assessment of causality and severity of recorded adverse events showed possible to probable and mild to moderate severity respectively.Conclusions: CNS and Anticholinergic side effects were most common adverse drug reactions noted. Tricyclic antidepressants (TCA) were most commonly prescribed drugs followed by Selective serotonin reuptake inhibitors (SSRIs). Tricyclic antidepressants (TCA) and Selective serotonin reuptake inhibitors (SSRIs) accounted for most of ADRs (87.8%). Assessment of causality of recorded adverse events showed no certain cause and assessment of severity of recorded adverse events showed no severe cases.

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What Happens With Adverse Events During 6 Months of Treatment With Selective Serotonin Reuptake Inhibitors?

The Journal of Clinical Psychiatry ◽

10.4088/jcp.v66n0708 ◽

2005 ◽

Vol 66 (07) ◽

pp. 859-863 ◽

Cited By ~ 25

Author(s):

Koen Demyttenaere ◽

Adelin Albert ◽

Patrick Mesters ◽

Walthère Dewè ◽

...

Keyword(s):

Adverse Events ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Serotonin Reuptake Inhibitors ◽

Selective Serotonin

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Efficacy and Tolerability of Moclobemide in Comparison with Placebo, Tricyclic Antidepressants, and Selective Serotonin Reuptake Inhibitors in Elderly Depressed Patients: A Clinical Overview

The Canadian Journal of Psychiatry ◽

10.1177/070674379704201005 ◽

1997 ◽

Vol 42 (10) ◽

pp. 1043-1050 ◽

Cited By ~ 15

Author(s):

Roman Amrein ◽

Max Stabl ◽

Stephan Henauer ◽

Eva Affolter ◽

Iris Jonkanski

Keyword(s):

Adverse Events ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Safety Data ◽

The Elderly ◽

Similar Efficacy ◽

Serotonin Reuptake Inhibitors ◽

Selective Serotonin ◽

Depressed Patients ◽

Tetracyclic Antidepressants

Objective: To review the efficacy and safety of moclobemide in comparison with TCAs(for our purposes, “TCAs” will represent tricyclic and tetracyclic antidepressants, including maprotilin and mianserin) and selective serotonin reuptake inhibitors (SSRIs) in elderly depressed patients. Methods: The efficacy data reviewed were obtained from the following sources: 1) results of published studies in the elderly; 2) data on patients aged ≥ 60 years extracted from all available controlled trials in adults (≥ 18 years) in which moclobemide was compared with TCAs or SSRIs; and 3) the adverse events were extracted for patients aged ≥ 60 years from the safety data base of all available comparative short-term studies with moclobemide versus TCAs, SSRIs, or placebo and of long-term studies with moclobemide. Results: The data show that moclobemide is an effective antidepressant in depressed patients aged ≥ 60 years. The response rate to moclobemide was 50% to 55% in this population. Moclobemide was more effective than placebo and was of similar efficacy to the TCAs and the more recently introduced SSRIs. The tolerability of moclobemide was rated as “very good” or “good” in almost 90% of these patients, which was better than the tolerability of TCAs and similar to that of SSRIs. Patients without any adverse events were more frequently found in the moclobemide group than in those treated with TCAs (P < 0.01) or SSRIs (P < 0.01). Adverse events of the anticholinergic type were more frequent with TCAs than with moclobemide (P < 0.001), and nausea was found 3 times more frequently with SSRIs than with moclobemide (P < 0.01). Conclusions: Moclobemide is an effective and well-tolerated antidepressant for the treatment of elderly depressed patients.

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Review: most selective serotonin reuptake inhibitors lead to adverse events that appear to outweigh the benefits in children

Evidence-Based Medicine ◽

10.1136/ebm.9.6.181 ◽

2004 ◽

Vol 9 (6) ◽

pp. 181-181

Author(s):

E J. Garland

Keyword(s):

Adverse Events ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Serotonin Reuptake Inhibitors ◽

Selective Serotonin

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Efficacy of selective serotonin reuptake inhibitors and adverse events: Meta-regression and mediation analysis of placebo-controlled trials

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.150136 ◽

2016 ◽

Vol 208 (2) ◽

pp. 114-119 ◽

Cited By ~ 23

Author(s):

Michael Barth ◽

Levente Kriston ◽

Swaantje Klostermann ◽

Corrado Barbui ◽

Andrea Cipriani ◽

...

Keyword(s):

Adverse Events ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Serotonin Reuptake Inhibitors ◽

Response To Treatment ◽

Selective Serotonin ◽

Controlled Trials ◽

Regression Analyses ◽

Double Blind ◽

Meta Regression

BackgroundIt has been suggested that the efficacy of antidepressants has been overestimated in clinical trials owing to unblinding of drug treatments by adverse events.AimsTo investigate the association between adverse events and the efficacy of selective serotonin reuptake inhibitors (SSRIs).MethodThe literature was searched to identify randomised, double-blind, placebo-controlled trials of SSRIs in the treatment of major depression. Efficacy outcomes were response to treatment and change in depressive symptoms. Reporting of adverse events was used as an indicator of tolerability. Random effects meta-analyses were used to calculate pooled estimates. Meta-regression analyses were performed to investigate the association between adverse events and efficacy. Potential mediation was investigated with the Baron & Kenny approach.ResultsA total of 68 trials (n = 17 646) were included in the analyses. In meta-analysis SSRIs were superior to placebo in terms of efficacy (odds ratio, OR = 1.62, 95% CI 1.51–1.72). More patients allocated to SSRIs reported adverse events than did patients receiving placebo (OR = 1.73, 95% CI 1.58–1.89). Meta-regression analyses did not find an association between adverse events and efficacy (P = 0.439). There was no indication of adverse events mediating the effect of SSRI treatment.ConclusionsOur results do not support, but also do not unequivocally disprove, the hypothesis that adverse events lead to an overestimation of the effect of SSRIs over placebo.

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