Antidepressant side-effects

Antidepressants used in general practice are similarly effective but differ in side-effects, a major new analysis concludes.

The review by the US Agency for Healthcare Research and Quality found 60 per cent of patients on second-generation antidepressants reported 'some relief' from their condition.

But 61 per cent also experienced at least one side-effect – including nausea, sexual dysfunction, anxiety, insomnia and suicidal thoughts. Between 25 and 33 per cent of patients improved with the addition or substitution of a different drug.

Dr Carolyn Clancy, director of the agency, said: 'Often trying to find the right drug is trial and error, and in many cases relief is temporary or comes with side-effects. We need more evidence to help patients and their doctors make the best choices.'

The analysis of 187 trials compared side-effects of second generation drugs. It concluded:

• venlafaxine has higher incidence of nausea and vomiting than SSRIs

• sertraline has a particular risk of diarrhoea

• mirtazapine leads to higher weight gains than fluoxetine, paroxetine, venlafaxine or

trazodone

• trazodone has a higher risk

of sleeplessness than a number of other antidepressants

• bupropion is less likely to cause sexual dysfunction than several other antidepressants

• paroxetine has higher rates of sexual dysfunction than fluoxetine, fluvoxamine, nefazodone, or sertraline.