How-To Guides

The most commonly reported side effects were flatulence (64%), somnolence (59%), memory impairment (51%), decreased concentration (50%), yawning (47%), fatigue (45%), dry mouth (45%), weight gain (45%), light headedness (43%), and sweating (38%). In this sample, commonly reported adverse effects were mainly gastrointestinal, neuropsychiatric, sexual, and constitutional symptoms.

Yes. Patients taking escitalopram had significantly higher rates of headache (χ2 = 6.522, P = .038), pruritus (χ2 = 9.910, P = .007), memory impairment (χ2 = 6.324, P = .042), decreased concentration (χ2 = 8.074, P = .018), and dizziness (χ2 = 10.162, P = .006) than patients taking the other SSRIs studied. For the other side effects measured, the study did not find significant differences among escitalopram, sertraline, and fluoxetine.

Yes. In this study, sertraline was associated with significantly decreased appetite compared with the other SSRIs studied (χ2 = 6.136, P = .047). The authors did not report other significant between-group differences favoring sertraline for the remaining side effects assessed.

Sexual side effects were reported by a large number of participants, although this study did not provide percentage rates for each sexual symptom. The sexual problems reported included reduced libido, anorgasmia, poor satisfaction with sexual life, delayed ejaculation, and erectile dysfunction. The authors note that these adverse effects are often underreported and are a major contributor to treatment discontinuation and poor adherence.

Yes. Sleep disturbances were common in this sample, and patients reported both somnolence and insomnia. Somnolence was one of the most frequent adverse effects overall, reported by 59% of participants.

This was a cross-sectional study in a naturalistic outpatient setting. It included 100 adults aged 18 years or older with ICD-10 psychiatric diagnoses who were taking SSRI monotherapy, and side effects were assessed with a 42-item self-rating instrument covering symptoms experienced in the past month.

Participants were recruited from a psychiatry department in a tertiary care hospital. The SSRI groups were 53% sertraline, 38% escitalopram, and 8% fluoxetine.

Within this sample, the 3 SSRI groups were similar in several basic characteristics. The authors found no significant statistical difference in age, sex, or duration of SSRI administration across patients taking sertraline, escitalopram, and fluoxetine, which supports comparison of side effect patterns across the groups.

The study included 100 adult outpatients with psychiatric disorders diagnosed by ICD-10 criteria who were taking SSRI monotherapy. Seventy percent were women, and the most common diagnosis was depression (49%), followed by panic disorder (14%) and obsessive-compulsive disorder (13%).

Patients were excluded if they were on combination therapy, had comorbid physical illness, had poor drug compliance, or were unwilling to provide consent.

The main limitations were that it was a small cross-sectional outpatient study using an assessment instrument, so rare side effects may have been missed. The study also did not account for diet or other confounding factors, including severity of illness, which could have influenced patients' subjective reports.

Because the study was cross-sectional, it could not establish causality for the full study population.

This study suggests that clinicians should actively ask about common SSRI adverse effects in routine practice, especially flatulence, somnolence, memory impairment, decreased concentration, dry mouth, weight gain, and light headedness. The authors also conclude that psychiatrists and other medical professionals prescribing SSRIs should be aware of these side effect profiles and educate patients about common adverse effects so that morbidity and treatment discontinuation can be reduced.