Sisay Tariku, Wami Roza
Department of Biomedical Sciences, College of Health Sciences, Mizan Tepi University, Mizan, Ethiopia.
Department of Clinical Pharmacy, Rift Valley University, Addis Ababa University, Ethiopia.
Heliyon. 2021 Dec 22;7(12):e08655. doi: 10.1016/j.heliyon.2021.e08655. eCollection 2021 Dec.
Although a significant crisis of adverse drug reaction (ADR) among major depressive disorders (MDDs) is not uncommon, research in Ethiopia has been limited. As a result, the goal of this study was to estimate the prevalence rate of ADRs among MDD patients by age and gender at the outpatient department of Amanuel mental specialized hospital (AMSH) in Addis Ababa, Ethiopia.
The study was conducted on 129 (61 men and 68 women) volunteers at the outpatient department of AMSH, Addis Ababa, Ethiopia, from November 2020-March 2021. A longitudinal cross-sectional study design was employed. All participants were between 35 and 72 years old, with a mean age of 49.5 (SD = 18.8). Patients who had been taking an antidepressant for at least one month and had a follow-up within the first three months after diagnosis and treatment initiation were included in the study. Antidepressant-related ADRs were assessed using the Naranjo ADR probability scale. Antidepressant side-effect checklist (ASEC) as all ADRs have been listed on it was also used to classify a mental state examination (MSE) into mild, moderate, and severe.
According to this study, the overall prevalence of antidepressant-related adverse reactions among MDD patients was 69%, with females having a higher prevalence rate. One of the study's unexpected findings was that ADR was significantly (p = 0.039) higher in young study subjects than in the elderly (73.1% versus 66.2%, respectively). ADRs were shown to be substantially more common in patients taking polypharmacy than in mono-pharmacy (72.5% versus 65%, respectively). The bulk of the ADRs reported were likely, moderate, and probably avoidable. The most common adverse effects reported by patients in the current study were weight gain in TCAs, followed by sexual dysfunction with SSRIs, nausea or vomiting in MAOIs, and headache in SNRIs. The prevalence of ADRs was higher in MAOIs (80%), while SSRIs had the lowest (62.5%). The prevalence of ADRs varies depending on comorbidities: 62.7 % in the absence of comorbidities versus 74.3% in the presence of comorbidities (those with one or more comorbidities).
ADRs that occur in MDD patients are considerable, and gender and age are associated with their occurrence. These findings underscore the importance of monitoring ADRs in mental outpatients frequently to recognize and decrease the risks posed by ADRs earlier. As a result, the quality of care may increase, total health care expenses may decrease, and adherence among patients with depression may improve.
尽管重度抑郁症（MDD）患者中药物不良反应（ADR）的重大危机并不罕见，但埃塞俄比亚的相关研究有限。因此，本研究的目的是在埃塞俄比亚亚的斯亚贝巴的阿马努尔精神专科医院（AMSH）门诊部，按年龄和性别估算MDD患者中ADR的患病率。
该研究于2020年11月至2021年3月在埃塞俄比亚亚的斯亚贝巴的AMSH门诊部对129名志愿者（61名男性和68名女性）进行。采用纵向横断面研究设计。所有参与者年龄在35至72岁之间，平均年龄为49.5岁（标准差=18.8）。研究纳入了服用抗抑郁药至少一个月且在诊断和开始治疗后的前三个月内有随访的患者。使用纳伦霍ADR概率量表评估与抗抑郁药相关的ADR。由于所有ADR都已列在抗抑郁药副作用清单（ASEC）上，因此也用于将精神状态检查（MSE）分为轻度、中度和重度。
根据本研究，MDD患者中与抗抑郁药相关的不良反应总体患病率为69%，女性患病率更高。该研究的意外发现之一是，年轻研究对象中的ADR显著高于老年人（分别为73.1%和66.2%，p = 0.039）。多药联合治疗的患者中ADR明显比单药治疗的患者更常见（分别为72.5%和65%）。报告的大多数ADR可能、中度且可能可避免。本研究中患者报告的最常见不良反应是三环类抗抑郁药导致体重增加，其次是选择性5-羟色胺再摄取抑制剂导致性功能障碍、单胺氧化酶抑制剂导致恶心或呕吐以及5-羟色胺去甲肾上腺素再摄取抑制剂导致头痛。单胺氧化酶抑制剂中ADR的患病率较高（80%），而选择性5-羟色胺再摄取抑制剂中最低（62.5%）。ADR的患病率因合并症而异：无合并症者为62.7%，有合并症者（有一项或多项合并症）为74.3%。
MDD患者中发生的ADR相当可观，性别和年龄与ADR的发生有关。这些发现强调了频繁监测精神科门诊患者ADR的重要性，以便更早地识别和降低ADR带来的风险。因此，护理质量可能会提高，总体医疗费用可能会降低，抑郁症患者的依从性可能会改善。
