Antidepressant side effects and their impact on treatment outcome in people with major depressive disorder: an iSPOT-D report.
Abstract
Side effects to antidepressant medications are common and can impact the prognosis
of successful treatment outcome in people with major depressive disorder (MDD). However,
few studies have investigated the severity of side effects over the course of treatment
and their association with treatment outcome. Here we assessed the severity of side
effects and the impact of treatment type and anxiety symptoms over the course of treatment,
as well as whether side effects were associated with treatment outcome. Participants
were N = 1008 adults with a current diagnosis of single-episode or recurrent, nonpsychotic
MDD. Participants were randomised to receive escitalopram, sertraline, or venlafaxine-extended
release with equal probability and reassessed at 8 weeks regarding Hamilton Rating
Scale Depression (HRSD17) and Quick Inventory of Depressive Symptomatology (QIDS-SR16) remission and response. Severity of side effects were assessed using the Frequency,
Intensity, and Burden of Side Effects Rating (FIBSER) scale and assessed at day 4
and weeks 2, 4, 6, and 8. Frequency, intensity, and burden of side effects were greatest
at week 2, then only frequency and intensity of side effects gradually decreased up
to week 6. Treatment type and anxiety symptoms did not impact the severity of side
effects. A greater burden-but not frequency or intensity-of side effects was associated
with poorer treatment outcome and as early as 4 days post-treatment. Together, this
work provides an informative mapping of the progression of side effects throughout
the treatment course and their association with treatment outcome. Importantly, the
burden of side effects that are present as early as 4 days post-treatment predicts
poorer treatment outcome and should be monitored closely. iSPOT-D: Registry name:
ClinicalTrials.gov. Registration number: NCT00693849.
Type
Journal articleSubject
HumansSertraline
Citalopram
Antidepressive Agents
Treatment Outcome
Depressive Disorder, Major
Adult
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https://hdl.handle.net/10161/24780Published Version (Please cite this version)
10.1038/s41398-021-01533-1Publication Info
Braund, Taylor A; Tillman, Gabriel; Palmer, Donna M; Gordon, Evian; Rush, A John;
& Harris, Anthony WF (2021). Antidepressant side effects and their impact on treatment outcome in people with major
depressive disorder: an iSPOT-D report. Translational psychiatry, 11(1). pp. 417. 10.1038/s41398-021-01533-1. Retrieved from https://hdl.handle.net/10161/24780.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Augustus John Rush
Adjunct Professor in the Department of Psychiatry and Behavioral Sciences

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