Major Research Findings

Side effects of antidepressant medications are common and can impact the prognosis of successful treatment outcome in people with major depressive disorder (MDD). 2 . However, few studies have investigated the severity of side effects over the course of treatment and their association with treatment outcome. This study assessed the severity of side effects and the impact of treatment type and anxiety symptoms over the course of treatment, as well as whether side effects were associated with treatment outcome. Participants were N=1008 adults with a current diagnosis of single-episode or recurrent, nonpsychotic MDD. Participants were randomized to receive escitalopram, sertraline, or venlafaxine-extended release with equal probability and reassessed at 8 weeks regarding Hamilton Rating Scale Depression (HRSD₁₇) and Quick Inventory of Depressive Symptomatology (QIDS-SR₁₆) remission and response.

Antidepressant side effects are a significant public health issue, associated with poor adherence, premature treatment discontinuation, and, rarely, significant harm. Older adults assume the largest and most serious burden of medication side effects. 1 . This study investigated the association between antidepressant side effects and genetic variation in the serotonin system in anxious, older adults participating in a randomized, placebo-controlled trial of the selective serotonin reuptake inhibitor (SSRI) escitalopram.

Reasons for Side Effects

Side effects of antidepressants are a result of the drugs influencing neurotransmitters in the brain, particularly serotonin and dopamine. These neurotransmitters regulate several crucial bodily functions, including mood, sleep, appetite, and energy levels. Antidepressants try to elevate mood and reduce anxiety by adjusting the levels of these neurotransmitters. However, altering neurotransmitter levels can lead to undesirable side effects.

Common Side Effects

Gastrointestinal

One of the most frequent side effects of antidepressants is gastrointestinal issues. These include nausea, vomiting, constipation, diarrhea, and indigestion. 2 .

Nervous System

Common side effects of antidepressants include headache, dizziness, drowsiness, insomnia, anxiety, tremors, sweating, and sexual dysfunction. 2 . Also, in older adults, SSRIs can affect the nervous system and may cause cognitive impairment, increased risk of falls, and sleep disturbances. 1 .

Other

Side effects of antidepressants can also include weight gain, weight loss, sexual dysfunction, dry mouth, and vision changes. 2 .

Managing Side Effects

Gastrointestinal

Managing gastrointestinal side effects can involve dietary changes, lifestyle modifications, and medication adjustments. For mild nausea and vomiting, consuming small, frequent meals can help. In cases of constipation, consuming foods rich in fiber, exercising, and staying well-hydrated are beneficial. If diarrhea occurs, it's crucial to stay hydrated and avoid irritating foods.

Nervous System

Managing nervous system side effects can include medication adjustments, rest, and stress management. For headaches, taking over-the-counter pain relievers, resting, and applying cold compresses to the affected area can be helpful. Dizziness may require moving slowly when standing up and using handrails if necessary. Drowsiness or insomnia may necessitate medication adjustments or lifestyle changes. In case of significant anxiety or tremors, consulting a doctor is advised to consider medication adjustments or psychotherapy.

Other

For weight gain or weight loss concerns, adopting healthy lifestyle modifications like dietary changes and exercise are crucial. If sexual dysfunction is a concern, consulting a doctor to explore medication adjustments or alternative treatment options is recommended.

Comparison of Studies

Commonalities

Both studies indicate that side effects of antidepressants can influence the success of treatment. They also reveal that side effects can emerge shortly after starting treatment. 2 .

Differences

The main difference between the two studies lies in the patient populations they targeted and the types of side effects investigated. One study focused on patients with major depressive disorder (MDD) and examined various side effects of different antidepressants. 2 . The other study focused on anxious older adults and investigated the side effects of the selective serotonin reuptake inhibitor (SSRI) escitalopram. 1 . Additionally, one study investigated how side effect severity influenced treatment outcomes, while the other explored the relationship between side effects and genetic variations.

Applying to Real Life: Considerations

These research findings demonstrate that side effects of antidepressants can affect the success of treatment. Therefore, it's crucial to discuss the occurrence and severity of side effects with a doctor when taking antidepressants and consider medication adjustments or treatment modifications as needed. Additionally, since side effects can appear shortly after starting treatment, it's essential to regularly consult with a doctor and report any side effect changes.

Limitations of Current Research

These studies investigated the relationship between side effects and treatment outcomes, but they did not delve into the causes or mechanisms behind these side effects. Also, the targeted patient populations are limited, so generalization requires caution.

Future Research Directions

Further research is necessary to unravel the causes and mechanisms behind antidepressant side effects. Additionally, investigating the prevalence and severity of side effects in various patient populations, along with their impact on treatment outcomes, can enable more informed treatment selection.

Conclusion

Side effects of antidepressants should be taken seriously because they can impact the success of treatment. It's crucial to discuss the occurrence and severity of side effects with a doctor and consider medication adjustments or treatment modifications as needed. Also, since side effects can appear shortly after starting treatment, it's essential to regularly consult with a doctor and report any side effect changes.