ssris: if at first you don't succeed, try again
TRANSCRIPT
Reactions 542 - 18 Mar 1995
SSRIs: if at first you don’t succeed,try again
Patients with depression who discontinue treatmentwith fluoxetine because of adverse effects may besuccessfully treated with another selective serotoninreuptake inhibitor (SSRI), such as sertraline, say DrsWalter Brown and Wilma Harrison from the US.Findings from their study indicated that fluoxetine andsertraline have different adverse effect profiles.
These researchers initiated sertraline therapy in 112patients with depression who had previouslydiscontinued treatment with fluoxetine because ofadverse effects. The median duration of fluoxetinetherapy was 4.8 months. The maximum dose was 120mg/day, with 100 patients receiving 20–40 mg/day. The3 most common adverse effects of at least moderateseverity experienced during fluoxetine treatment wereinsomnia (28% of patients), agitation (20%) and anxiety(16%).
Almost 80% of the patients successfully completed 8weeks of treatment with sertraline 50–200 mg/day.Treatment was discontinued prematurely because ofadverse effects in 11 patients. The same adverse effectas experienced with fluoxetine occurred in 4 of thesepatients. The 3 most common adverse effects of at leastmoderate severity experienced during sertralinetreatment were insomnia (24% of patients), headache(20%) and somnolence (10%).
The researchers concluded that both fluoxetine andsertraline are associated with GI symptoms, insomnia,sexual dysfunction and somnolence. However, theybelieve that fluoxetine may be more commonlyassociated with agitation, while diarrhoea may occurmore frequently in sertraline recipients.Brown WA, et al. Are patients who are intolerant to one serotonin selectivereuptake inhibitor intolerant to another? Journal of Clinical Psychiatry 56: 30-34,Jan 1995 800341460
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Reactions 18 Mar 1995 No. 5420114-9954/10/0542-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved