Early Adverse Events and Attrition in SSRI Treatment: A Suicide Assessment Methodology Study (SAMS) Report

Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390-9119, USA.
Journal of clinical psychopharmacology (Impact Factor: 3.24). 06/2010; 30(3):259-66. DOI: 10.1097/JCP.0b013e3181dbfd04
Source: PubMed


Adverse events during selective serotonin reuptake inhibitor (SSRI) treatment are frequent and may lead to premature treatment discontinuation. If attrition is associated with early worsening of adverse effects or the frequency, intensity, or burden of adverse effects, interventions to maximize retention could be focused on patients with these events. Outpatient participants (n = 265) with nonpsychotic major depressive disorder entered an 8-week trial with an SSRI. At baseline and week 2, specific adverse effects were evaluated with the Systematic Assessment for Treatment Emergent Events--Systematic Inquiry, and at week 2, the Frequency, Intensity, and Burden of Side Effects Rating globally assessed adverse effects. Attrition was defined by those participants who left treatment after week 2 but before week 8. No specific week 2 adverse effect, either treatment-emergent or with worsening intensity, was independently associated with attrition. Global ratings of adverse effect frequency, intensity, or burden at week 2 were also not associated with subsequent attrition. Neither global ratings nor specific adverse effects at week 2 were related to patient attrition during SSRI treatment. Other factors seem to contribute to patient decisions about continuing with treatment.

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    • "It appears that adverse effects induced by SSRIs or NARIs are only one factor important in treatment adherence. This is supported by a previous study of 265 depressed individuals receiving an SSRI which reported no evidence of an association between any single adverse effects, or overall adverse effect rating, with discontinuation (Warden et al. 2010). "
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