Review: Problems associated with long-term treatment with selective serotonin reuptake inhibitors

NeuroBiz Consulting & Communication, Castres, France.
Journal of Psychopharmacology (Impact Factor: 3.59). 11/2009; 23(8):967-74. DOI: 10.1177/0269881108093582
Source: PubMed


Although the selective serotonin reuptake inhibitors (SSRIs), which are now widely used as a first-line treatment for depression and many other psychiatric conditions, are generally well tolerated, they are not devoid of side effects. Most short-term treatment-related side effects of SSRIs are transient and disappear after a few days or weeks. However, following long-term treatment with the SSRIs, some serious adverse events may occur. Some of them can be difficult to recognise because they can resemble residual symptoms of depression. The most serious can be life threatening. They all have a negative influence on the patient's quality of life and are frequently a prime reason for a lack of long-term compliance with the associated increased risk of recurrence of a depressive episode. This article is an overview of the more common adverse events, which are seen with non-acute treatment with the SSRIs.

Full-text preview

Available from:
  • Source
    • "Although a number of adverse effects have been associated with SSRIs (Moret et al. 2009), sexual difficulties remain an underestimated but important problem (Safarinejad 2011). "

    Full-text · Article · May 2014 · Australian Journal of Primary Health
  • Source
    • "Thus one in nine adults, and one in six women are prescribed ADs every year. The adverse effects most commonly studied and reported, by researchers (Moret et al., 2009; Uher et al., 2009) and drug companies (Ely Lilly, 2012) are physical symptoms such as diarrhea , dry mouth, dyspepsia, impotence, insomnia, nausea, sweating and tremors. A study of 811 AD recipients (Uher et al., 2009) produced rates for Nortriptyline from 3% (diarrhea) to 72% (dry mouth) and for Escitalopram from 3% (disorientation) to 23% (dry mouth). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background In the context of rapidly increasing antidepressant use internationally, and recent reviews raising concerns about efficacy and adverse effects, this study aimed to survey the lived experience of the largest sample of AD recipients to date. Methods An online questionnaire about experiences with, and beliefs about, antidepressants was completed by 1829 adults who had been prescribed antidepressants in the last five years (53% were first prescribed them between 2000 and 2009, and 52% reported taking them for more than three years). Results Eight of the 20 adverse effects studied were reported by over half the participants; most frequently Sexual Difficulties (62%) and Feeling Emotionally Numb (60%). Percentages for other effects included: Feeling Not Like Myself - 52%, Reduction In Positive Feelings - 42%, Caring Less About Others - 39%, Suicidality - 39% and Withdrawal Effects - 55%. Total Adverse Effect scores were related to younger age, lower education and income, and type of antidepressant, but not to level of depression prior to taking antidepressants. Conclusions The adverse effects of antidepressants may be more frequent than previously reported, and include emotional and interpersonal effects.
    Full-text · Article · Apr 2014
  • Source
    • "Nausea, which is the most common side effect, usually resolves within 4–5 days, and does not return each cycle when the treatment is given intermittently (Eriksson et al. 2008). In contrast, sexual dysfunction, including diminishing libido and anorgasmia, is usually persistent, and may, with long-term treatment, have negative consequences on relationships (Howland 2007; Moret et al. 2009) or result in non-compliance (Nurnberg 2008). However, sexual functioning recovers rapidly after discontinuation of treatment with SSRIs, which means that it is not influenced during symptom-free intervals in patients given intermittent treatment. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The second consensus meeting of the International Society for Premenstrual Disorders (ISPMD) took place in London during March 2011. The primary goal was to evaluate the published evidence and consider the expert opinions of the ISPMD members to reach a consensus on advice for the management of premenstrual disorders. Gynaecologists, psychiatrists, psychologists and pharmacologists each formally presented the evidence within their area of expertise; this was followed by an in-depth discussion leading to consensus recommendations. This article provides a comprehensive review of the outcomes from the meeting. The group discussed and agreed that careful diagnosis based on the recommendations and classification derived from the first ISPMD consensus conference is essential and should underlie the appropriate management strategy. Options for the management of premenstrual disorders fall under two broad categories, (a) those influencing central nervous activity, particularly the modulation of the neurotransmitter serotonin and (b) those that suppress ovulation. Psychotropic medication, such as selective serotonin reuptake inhibitors, probably acts by dampening the influence of sex steroids on the brain. Oral contraceptives, gonadotropin-releasing hormone agonists, danazol and estradiol all most likely function by ovulation suppression. The role of oophorectomy was also considered in this respect. Alternative therapies are also addressed, with, e.g. cognitive behavioural therapy, calcium supplements and Vitex agnus castus warranting further exploration.
    Full-text · Article · Apr 2013 · Archives of Women s Mental Health
Show more