Posted by garnet71 on May 26, 2009, at 0:43:31
Psychopharmacology
Unusual and Serious Adverse Effects of SSRIs: Recognition and ManagementJournal of Psychosocial Nursing and Mental Health Services Vol. 45 No. 3 March 2007
By Robert H. Howland, MD
EXCERPT
The selective serotonin reuptake inhibitor (SSRI) antidepressant agents fluvoxamine (Luvox®), fluoxetine (Prozac®), paroxetine (Paxil®), sertraline (Zoloft®), citalopram (Celexa®), and escitalopram (Lexapro®) are commonly used, generally well tolerated, and considered safe, especially compared with the older-generation tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) (Howland & Thase, 2002). Because of their potent effects on serotonin reuptake, SSRIs are associated with various noxious (Masand & Gupta, 1999) and sometimes serious adverse effects (Ener, Meglathery, Van Decker, & Gallagher, 2003). In last months Psychopharmacology article, I focused on some of the most common and clinically important side effects of SSRIs. In this article, I will review more unusual and serious adverse effects associated with SSRIs.
Unusual Adverse Effects In the central nervous system,the neurotransmitters serotonin and dopamine interact with each other (Rothman &
Baumann, 2006). A secondary effect of boosting serotonin is to down-regulate, or decrease,
dopamine activity in certain regions of the brain. One area where serotonin and dopamine
interact is in the frontal lobes (Levy & Czernecki, 2006).Apathy
Extrapyramidal Symptoms
Increased Prolactin Levels
Hyponatremia
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Dr. Howland is Associate Professor
of Psychiatry, University of Pittsburgh
School of Medicine, Western Psychiatric
Institute and Clinic, Pittsburgh, Pennsylvania.
The author discloses that he has
no significant financial interests in any
product or class of products discussed
directly or indirectly in this activity,
including research support.
Address correspondence to Robert
H. Howland, MD, Associate Professor
of Psychiatry, University of Pittsburgh
School of Medicine, Western Psychiatric
Institute and Clinic, 3811 OHara
Street, Pittsburgh, PA 15213; e-mail:
HowlandRH@upmc.edu.
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