scholarly journals Review: selective serotonin reuptake inhibitors differ from tricyclic antidepressants in adverse events

1998 ◽  
Vol 1 (2) ◽  
pp. 50-50 ◽  
Author(s):  
M. Hotopf
Author(s):  
Swetha Munoli ◽  
Soumya B. Patil

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.


Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Jou Wei Lin ◽  
Chia-Hsuin Chang ◽  
Chin-Hsien Lin

Background: The objective of this study was to examine the effects of selective serotonin reuptake inhibitors (SSRIs) versus tricyclic antidepressants (TCAs) on cerebrovascular events in patients with depression or anxiety. Methods: We performed a retrospective cohort study in a nationwide population. The patients who started to take SSRIs and TCAs with a diagnosis of depression or anxiety between January 1, 2001 and December 31, 2009 were identified from the Taiwan National Health Insurance claims database. We examined the association between the two types of antidepressants and incidence of stroke using a proportional hazard model adjusted for risk factors for stroke. Results: Among of the 24,662 SSRI and 14,736 TCA initiators, the crude incidence rate for stroke was 10.03 and 13.77 per 100 person-years respectively. SSRI use was associated with a significantly reduced risk as compared with TCAs with the adjusted hazard ratio of 0.67 (95% confidence interval 0.47 to 0.96) in a dose-dependent manner. No significant effect modification was found among subgroups, such as hypertension, diabetes, previous cardiovascular and cerebrovascular diseases. The adjusted hazard ratio was 1.09 (95% confidence interval 0.65 to 1.85) for those aged more than 65 years, suggesting only a potential trend for a higher risk of stroke with SSRIs in the geriatric group. Conclusions: As compared with TCAs, the use of SSRIs was associated with a reduced risk for cerebrovascular events in a clear dose-response manner. Further researches are needed to examine the potential risk and benefit of SSRI use for patients with high risk of stroke.


2010 ◽  
Vol 41 (1) ◽  
pp. 15-17 ◽  
Author(s):  
C. M. Pariante ◽  
G. Seneviratne ◽  
L. Howard

A new Swedish study by Reis & Källén describes approximately 15 000 women (and their babies) that, between 1995 and 2007, reported the use of antidepressants, or were prescribed such drugs, during pregnancy. In this study, pregnancy and teratogenic outcomes after exposure to tricyclic antidepressants are, for most measures, equal or worse than after exposure to selective serotonin reuptake inhibitors or other antidepressants. Based on this and on a review of the few other studies available (admittedly, a relatively small number of women on which conclusions can be based), the authors of this Editorial challenge the ‘perinatal myth’ that tricyclics are the safest choice in pregnancy.


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