Research Activities January 2013, No. 389
Headache and nausea most common side effects among adults and adolescents taking antidepressants
Much of what we know about the side effects of antidepressants comes from randomized trials. A new study sheds light on side effects of antidepressants observed in patients being treated by clinicians in a real-world setting. The side effects varied, depending on the class of drug and age of the patient.
The University of Colorado researchers reviewed 11 years of data to identify 36,400 adults and 3,617 adolescents who received an antidepressant to treat a new episode of major depressive disorder. They studied seven classes of antidepressants for side effects: serotonin reuptake inhibitors (SSRIs), selected serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclics, bupropion, monoamine oxidase inhibitors (MAOIs), phenylpiperazine, and tetracyclic antidepressants. They also studied the prevalence of five of the most common side effects: headache, nausea/vomiting, agitation, sedation, and sexual dysfunction.
Most patients were taking SSRIs (66 percent), followed by bupropion (14 percent), and SNRIs (12 percent). Within the SSRI group, the most popular drugs were sertraline, escitalopram, and fluoxetine. Two-thirds of patients receiving an SNRI took venlafaxine. Patients taking MAOIs were significantly older than patients taking other classes of drugs.
The most common side effects among all age groups were headache and nausea or vomiting. Adults receiving bupropion had significantly fewer episodes of headaches and nausea compared to those taking an SSRI or SNRI. Adolescents receiving bupropion had significantly less nausea or vomiting compared to those taking an SSRI. Among adults taking an SSRI, there was a higher risk of nausea. Adolescents were more at risk for headaches if they were taking a tetracyclic antidepressant verses an SSRI. The results of this study were consistent with data from previous clinical trials. The study was supported by the Agency for Healthcare Research and Quality (HS19464 and Contract No. 290-05-0037).
See "Rates of 5 common antidepressant side effects among new adult and adolescent cases of depression: A retrospective US claims study," by Heather D. Anderson, PhD, Wilson D. Pace, MD, Anne M. Libby, PhD, and others in the January 2012 Clinical Therapeutics 34(1), pp. 113-123.