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De.mediguard.org

KEY WORDS
SSRI, antidepressant, patient-
reported side effect, real-world
data
INTRODUCTION
care by the physician is limited, itis important for practicingphysicians to understand whichissues to prioritize in their patientinteractions. In this article, weprovide information on patient-reported side effects from a cross-section of real-world patients usingselective serotonin reuptakeinhibitors (SSRIs).
monitoring service, randomlysurveys enrolled patients on acontinuous basis to obtain data ontreatment satisfaction, efficacy, andside effects using a validated,patient-reported, outcomesinstrument called the Treatment Real-World Data on SSRI Satisfaction Questionnaire for
Medications (TSQM). Data on sideeffects were tabulated for patients Antidepressant Side Effects taking one of the following SSRI
escitalopram, fluoxetine,paroxetine, and sertraline. Please Psychiatry (Edgemont) 2009;6(2):16–18 have been taking other centralnervous system (CNS) and non-CNS products concurrently with ABSTRACT
Psychiatry 2009 [ V O L U M E 6 , N U M B E R 2 , F E B R U A R Y ]
Content redistributed with permission from Innovations in Clinical Neuroscience (formerly Psychiatry [Edgemont]. Copyright 2009. Matrix Medical Communications. All rights reserved.
commonly mentioned items. Onlyabout one-quarter of these patients(26%), however, indicated thatthese side effects were “verybothersome” or “extremelybothersome” (Figure 2).
patients who discuss side effectswith their prescribing physicians.
As seen in Figure 3, only 39percent of patients reported sideeffects to their physicians.
Interestingly, the proportion ofpatients reporting side effects totheir physicians was the same forall patients, including those whoconsidered the side effects “verybothersome” or “extremely FIGURE 1. Analysis of www.iGuard.org data for citalopram, escitalopram, fluoxetine, paroxetine, and
sertraline showing the most commonly patient-reported side effects EXPERT COMMENTARY
by Sidney H. Kennedy, MD, FRCPC
debate has existed for many years.
It was the beneficial side-effectprofile of fluoxetine thatdifferentiated it from tricyclicantidepressants after the drug waslaunched in 1988. There was nodoubt that the reduction in cardiacarrhythmias and other potentiallethalities played a major role inopening the door to theexponential growth ofantidepressant prescribing. Withgrowing recognition of the need forlong-term antidepressant use andattention to quality of life, attemptsto minimize antidepressant sideeffects and drug discontinuation FIGURE 2. Analysis of www.iGuard.org data for citalopram, escitalopram, fluoxetine, paroxetine, and
sertraline showing percentage of patients who ranked side effects as “bothersome.”
Content redistributed with permission from Innovations in Clinical Neuroscience (formerly Psychiatry [ V O L U M E 6 , N U M B E R 2 , F E B R U A R Y ] Psychiatry 2009
[Edgemont]. Copyright 2009. Matrix Medical Communications. All rights reserved.
polymorphism status for theserotonin transporter influencingSSRI side-effect reporting.
Neuroticism as a personalitydimension has also been shown toinfluence side-effect reporting,even with placebo, with high levelsof neuroticism increasing sideeffects. Other variables thatcontribute to drug tolerabilityinclude time of dosing, intake withor without food, and smokingstatus. All of these factors shouldbe considered duringantidepressant therapy to promoteoptimal response.
AUTHOR AFFILIATIONS: Ms. Cascade is
FIGURE 3. Analysis of www.iGuard.org data for citalopram, escitalopram, fluoxetine, paroxetine, and
Vice President, Quintiles Inc./iGuard, Falls sertraline. Left bar indicates the percentage of total patients who reported side effects to their physicians; right bar indicates the percentage of the subset of patients who ranked their side effects as “very” or “extremely bothersome” and reported their symptoms to their physicians.
President, Global Therapeutic Group Leader CNS, Quintiles Inc., San Diego, California, and Professor of Psychiatry, University of ADDRESS CORRESPONDENCE TO:
Quintiles, Inc./iGuard, 3130 Fairview Park Drive, Suite 501, Falls Church, VA 22042; Psychiatry 2009 [ V O L U M E 6 , N U M B E R 2 , F E B R U A R Y ]
Content redistributed with permission from Innovations in Clinical Neuroscience (formerly Psychiatry [Edgemont]. Copyright 2009. Matrix Medical Communications. All rights reserved.

Source: https://de.mediguard.org/static/documents/articles_posters_presentations/Real_World_Data_on_SSRIs.pdf