Which adverse effects influence the dropout rate in selective serotonin reuptake inhibitor (SSRI) treatment? Results for 50,824 patients.
BACKGROUND
Nowadays, selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed antidepressants due to their superior clinical efficacy, effectiveness, tolerability, and safety as compared to tricyclic antidepressants or monoamino oxidase inhibitors. However, despite these advantages SSRIs are still associated with a number of adverse drug reactions, especially in the early stages of treatment, which may lead to premature discontinuation of therapy in some cases. The aim of the present study was to assess the most common adverse drug reactions of SSRIs as well as their impact on dropout rate in a large study population.


PATIENTS AND METHODS
Data for 50,824 patients treated for major depressive disorder with SSRIs for the first time was accessed via the Disease Analyzer database (IMS Health, Germany), providing information on SSRI adverse drug reactions and their influence on premature treatment discontinuation calculated by regression analysis. The presence of certain co-morbidities was also registered.


RESULTS
The mean age was 54.5 ± 19 years, two-thirds of the study population being female. The adverse effects mentioned most frequently were: "discomfort" of the digestive system (10%), sleep disorders (8.6%), and heart rhythm disorders (4%); however, these were of tolerable severity as they did not significantly influence the dropout rate. Contrary to that, somnolence and younger age (≤50 years) in particular increased the chance of premature treatment discontinuation, while patients suffering from cardiovascular risk factors or osteoporosis tended to adhere to the therapy.


CONCLUSIONS
Overall, there is high tolerability for early SSRI treatment, whereas the occurrence of somnolence leads to discontinuation.
['Kostev|Karel|K|', 'Rex|Juliana|J|', 'Eith|Thilo|T|', 'Heilmaier|Christina|C|']
D000328:Adult D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D000928:Antidepressive Agents D001145:Arrhythmias, Cardiac D003865:Depressive Disorder, Major D004066:Digestive System Diseases D005260:Female D006801:Humans D008297:Male D055118:Medication Adherence D008875:Middle Aged D012307:Risk Factors D017367:Serotonin Uptake Inhibitors D012893:Sleep Wake Disorders
dropout selective serotonin reuptake inhibitors antidepressants adverse drug reactions