Mishra Swati, Swain Trupti Rekha, Mohanty Manjushree
Assistant Professor, IMS & SUM Hospital, SOA University , Bhubaneswar - 03, Odisha, India .
J Clin Diagn Res. 2013 Jun;7(6):1131-4. doi: 10.7860/JCDR/2013/4985.3041. Epub 2013 Jun 1.
Depression is a prevalent mental disorder and the 4(th) leading cause of disability in the world as per the World Health Organization (WHO). The adverse Drug Reactions (ADRs) to antidepressants are common and they can lead to a non compliance or even a discontinuation of the therapy. This study entitled us to monitor the ADR profile of the antidepressants in a tertiary care teaching hospital.
A longitudinal, observational study was conducted in the Outpatients Department of Psychiatry in S.C.B. Medical College and Hospital l in collaboration with the I.M.S and SUM Hospital. A total of 160 cases were studied for ADRs by using a predesigned CDSCO form. The patients who were on TCAs, SSRIs and newer antidepressants (SNRIs/NDRIs) were assessed by doing physical examinations, neurological examinations and relevant lab tests. The causalities were assessed by the criteria of the WHO-UMC. The analysis of ADRs was done by using the Chi square test.
Among the 160 patients who took antidepressants, 26.87% reported ADRs, with at least one possible causality.None were labeled as certain, as a rechallenge was not performed.ADRs were mostly observed in polytherapy (14.37%) and with antidepressants like TCAs (58.84%).
Agitation, anxiety and insomnia were the common ADRs which were associated with the use of antidepressants. This study offers a representative profile of the ADRs which can be expected in the Psychiatry Outpatients Department and due care must be taken to avoid these ADRs.
抑郁症是一种常见的精神障碍，根据世界卫生组织（WHO）的数据，它是全球第四大致残原因。抗抑郁药的不良反应很常见，可能导致治疗依从性差甚至停药。这项研究使我们能够监测一家三级护理教学医院中抗抑郁药的不良反应情况。
在S.C.B.医学院和医院的精神病科门诊与I.M.S和SUM医院合作进行了一项纵向观察性研究。使用预先设计的CDSCO表格对总共160例患者的不良反应进行了研究。对服用三环类抗抑郁药（TCAs）、选择性5-羟色胺再摄取抑制剂（SSRIs）和新型抗抑郁药（5-羟色胺-去甲肾上腺素再摄取抑制剂/去甲肾上腺素-多巴胺再摄取抑制剂）的患者进行了体格检查、神经学检查和相关实验室检查。根据WHO-UMC标准评估因果关系。使用卡方检验对不良反应进行分析。
在160例服用抗抑郁药的患者中，26.87%报告了不良反应，至少有一个可能的因果关系。由于未进行再激发试验，无一例被标记为肯定。不良反应大多在联合治疗中观察到（14.37%），在使用三环类抗抑郁药等抗抑郁药时出现（58.84%）。
激动、焦虑和失眠是与使用抗抑郁药相关的常见不良反应。这项研究提供了精神病科门诊可能出现的不良反应的代表性概况，必须谨慎避免这些不良反应。
