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This is a blog about the scientific basis of medicine. A judo therapist reads research papers for study and writes about them.

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Duration of antidepressant side effects and their impact on treatment outcome.

Tuesday, August 10, 2021

Depression

Adverse effects of antidepressants and their impact on treatment outcomes in people with major depressive disorder: iSPOT-D report

Braund, TA, Tillman, G., Palmer, DM etal. Side effects of antidepressants and their impact on treatment outcomes in people with major depressive disorder: the iSPOT-D report. TRANSL Spirit 11, 417 (2021). https://doi.org/10.1038/s41398-021-01533-1

Commentary

The purpose of this study was to assess the severity of side effects of antidepressants and their impact on the type of treatment and anxiety symptoms during the course of treatment and whether side effects are related to treatment outcome.

Participants in the study were N = 1008 adults with a diagnosis of single-episode, recurrent, non-psychotic MDD.

Participants were randomized to receive escitalopram, sertraline, and venlafaxine extended-release at equal rates and received an 8-week intervention on the Hamilton Rating Scale for Depression (HRSD).

The severity of side effects was assessed using the Frequency, Intensity, and Burden of Side Effects Rating (FIBSER) scale and was assessed on day 4 and at weeks 2, 4, 6, and 8.

The frequency, intensity, and burden of side effects decreased gradually during week 2, then only the frequency and intensity of side effects continued until week 6.

The type of treatment and anxiety symptoms had no effect on the severity of side effects. A greater burden of side effects was found to be associated with lower treatment outcomes and as early as 4 days after treatment.

What is important about this result is that the burden of side effects present as early as 4 days post-treatment should be closely monitored as it predicts worse outcomes.

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