Other patients do not attribute adverse events to the use of a drug, and instead think they are getting the “flu” or completely fail to report their symptoms to the doctor. Patients may not be comfortable discussing an adverse event such as sexual dysfunction unless the clinician specifically asks about it. During clinical trials, adverse event data are typically captured through spontaneous reports volunteered by the patient, open-ended questioning by the clinician, and changes in laboratory values and results of physical examinations. Trial design, methods for determining adverse events, and the duration of the studies may have affected the emergence or reporting of side effects. Why have the frequency and type of side effects with SSRIs increased with time? Dosages used in early clinical trials may not have been sufficient to allow for a full understanding of the side effect profile of the drugs. Consequently, more patients are now successfully treated for depression than ever before. Because of their overall efficacy, safety, and tolerability, they have become widely prescribed by primary care physicians. SSRIs also could be prescribed for patients with multiple comorbidities. Unlike the TCAs, they could be used safely in many patient populations, including the elderly and children, both of whom are particularly sensitive to the adverse effects of TCAs. 1 Thus, development of the SSRIs was an important milestone in the treatment of depression.Ĭompared with the TCAs, SSRIs were initially considered almost free of side effects. 4 Unlike TCAs, SSRIs do not cause cardiac conduction abnormalities in overdose and have low propensity to cause seizures. 3 This was confirmed by the finding that fewer patients taking an SSRI discontinued therapy because of adverse effects than did those taking TCAs. Although the efficacy of the SSRIs is comparable to that of the TCAs, the SSRIs have significantly fewer side effects. Other SSRIs were soon introduced in the United States and elsewhere ( Table 1). The adverse effect profile of fluoxetine was far superior to that of any other available antidepressant because of its selectivity for serotonin receptors. In 1988, the first SSRI, fluoxetine, was introduced in the United States.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |