Read John, Williams James
School of Psychology, University of East London, Stratford, London E15 4LZ, United Kingdom.
Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia.
Curr Drug Saf. 2018;13(3):176-186. doi: 10.2174/1574886313666180605095130.
Studies of the adverse effects of antidepressants tend to focus on biological symptoms. The prevalence of suicidality and withdrawal effects are currently a source of controversy.
To directly ascertain the experiences of an international sample of antidepressant users.
An online survey asked adult antidepressant users whether they had experienced 20 adverse effects 'as a result of taking the antidepressant', and if so, to what degree of severity. 1,431 people, from 38 countries, responded.
61% of the respondents reported at least ten of the 20 adverse effects, most commonly: 'Feeling emotionally numb' (reported by 71%), 'Feeling foggy or detached' (70%); 'Feeling not like myself' (66%), 'Sexual difficulties' (66%), 'Drowsiness' (63%), and 'Reduction in positive feelings' (60%). 'Suicidality' as a result of the drugs was reported by 50%. Withdrawal effects were reported by 59%, and 'Addiction' by 40%. Rates of adverse effects were higher for those prescribed multiple antidepressants and those who also took antipsychotics. Younger age and longer use of ADs were positively related to total adverse effects. One third did not recall being told about any side effects by the prescriber. Less than 5% were told about suicidality, emotional numbing, withdrawal effects or addiction.
Asking people directly reveals far higher rates of adverse responses to antidepressants than previously understood, especially in the emotional, psychological and interpersonal domains. Given recent findings that antidepressants are only marginally more effective than placebo, the findings of the current study imply a cost-benefit analysis that cannot justify the extremely high prescription rates for these drugs.
对抗抑郁药不良反应的研究往往集中在生物学症状上。自杀倾向和戒断反应的发生率目前存在争议。
直接了解国际上抗抑郁药使用者的经历。
一项在线调查询问成年抗抑郁药使用者是否“因服用抗抑郁药”经历过20种不良反应，若有，严重程度如何。来自38个国家的1431人进行了回应。
61%的受访者报告称在这20种不良反应中至少经历了10种，最常见的有：“情感麻木感”（71%的人报告）、“感觉迷糊或超脱”（70%）、“感觉不像自己”（66%）、“性功能障碍”（66%）、“嗜睡”（63%）以及“积极情绪减少”（60%）。5%的人报告称因药物导致有“自杀倾向”。59%的人报告有戒断反应，40%的人报告有“成瘾”情况。服用多种抗抑郁药的人和同时服用抗精神病药物的人不良反应发生率更高。年龄较小以及使用抗抑郁药时间较长与总的不良反应呈正相关。三分之一的人不记得开处方的医生告知过任何副作用。不到5%的人被告知过自杀倾向、情感麻木、戒断反应或成瘾情况。
直接询问人们发现，抗抑郁药不良反应的发生率远高于此前的认知，尤其是在情感、心理和人际方面。鉴于近期的研究发现抗抑郁药仅比安慰剂略有效，本研究结果意味着成本效益分析无法证明这些药物极高的处方率是合理的。
