A Cross-Sectional Study of the Prevalence of Cognitive and Physical Symptoms During Long-Term Antidepressant Treatment
J Clin Psychiatry 2006;67:1754-1759
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Antidepressant therapies have
been associated with a variety of side effects of both
physical and psychological nature. Until recently, however,
the majority of the studies focusing on side effects of
antidepressants have not routinely included assessment
of cognitive side effects. The purpose of the present
work is to examine cross-sectionally the prevalence of
cognitive and physical side effects of antidepressants
during long-term treatment of depression.
Method: Patients at least 18 years of age who
were deemed responders to antidepressant therapy
following at least 3 months of treatment for major depressive
disorder (MDD) (diagnosed according to DSM-IV
criteria) and whose MDD was considered to be in partial or
full remission were eligible for inclusion in this study.
Eligible patients were enrolled between January 2003
and December 2004. Study participants were
administered the Harvard Department of Psychiatry/National
Depression Screening Day (HANDS) scale, the
Epworth Sleepiness Scale, the Brief Fatigue Inventory, the
Massachusetts General Hospital Cognitive and
Physical Functioning Questionnaire (CPFQ), and a
study-specific questionnaire inquiring about the emergence of
specific side effects such as apathy, fatigue, and inattentiveness.
Results: 117 MDD patients (mean ± SD age: 43.4
± 12.6 years; women: N = 78 [66.7%]) met criteria
for response according to the HANDS (score < 9).
Cognitive symptoms (apathy, inattentiveness,
forgetfulness, word-finding difficulty, and mental slowing) were
each reported on both the CPFQ and the study-specific
questionnaire by more than 30% of the responders on
antidepressants. The physical symptoms of fatigue and
sleepiness/sedation were reported by over 40% of
the responders on both the CPFQ and the
study-specific questionnaire. A significant, positive relationship
was found between the CPFQ and the severity of
residual depressive symptoms as measured by the HANDS
total score (F = 15.3, p = .0002).
Conclusion: Physical and cognitive symptoms
are frequently reported by MDD patients who have
responded to antidepressants and are treated in the
long term with these agents. It is likely that these
symptoms are both side effects of the antidepressants as well
as residual symptoms of MDD.