Time period of side effects To further understand side effects and their impact on patients’ quality of life and compliance, it. is also important to be aware of the time

when certain side effects present. While there is common belief that side effects can be classified as acute or chronic, a review by Papakostas9 challenged this idea. In it, he cites Hu et al’s1 study that. shows that although certain side effects may present, early or later in the course of treatment, many of those that arc considered acute persist #this website keyword# to a point that they should be considered chronic. In this stud}1, SSRI-induced side effects such as insomnia, sexual dysfunction, and drowsiness that are often considered acute persisted at 3 months. On the other hand, some side effects such as nausea do start early in the course of treatment, and then usually improve, while others such as weight, gain are not. present initially but emerge over time.

Inhibitors,research,lifescience,medical Another naturalistic study by Demyttenaere et al3 of 272 outpatients Inhibitors,research,lifescience,medical on an SSRI, trazodone, venlafaxine, or moclobemide looked at the time period that patients discontinue treatment secondary to side effects, and found that patients who cited side effects as their reason for discontinuation dropped out. of treatment at a mean period of 6.5 weeks. This study showed that side effects and lack of efficacy led to the earliest, discontinuation of antidepressants (at 6.5 weeks and 7 weeks respectively), followed by other reasons such as “fear of drug dependence” and “feeling better” that Inhibitors,research,lifescience,medical occurred at 8 weeks and later. Reinforcing the conclusion that side effects often account for early discontinuation, Bull et al10 found that significantly more patients discontinued or switched their SSRI because of an adverse effect, within the first. 3 months of treatment compared with the second 3 months. Side effects as predictors of response Although there are no systematic studies to our knowledge that address specific treatment-emergent adverse effects as predictors of response, we are aware that optimistic colleagues

Inhibitors,research,lifescience,medical sometimes look for certain early side effects, such as activation or insomnia, as favorable prognosticators. the Emerging biomarkers, such as quantitative electroencephalography11 or neuroimaging,12 alone or in conjunction with clinical features at. baseline and during treatment, represent, an important area of current research. Nevertheless, while the presence of particular side effects has no known prognostic significance, when patients have no side effects and minimal response despite full doses of an antidepressant, it is reasonable to rc-cvaluate medication adherence as well as to consider the possibility of drug-drug interactions (particularly metabolic induction) and genetic polymorphism that might call for higher doses to achieve an optimal outcome.