Authors: Astrid Chevance; Anneka Tomlinson; Philippe Ravaud; Suzanne Touboul; Catherine Henshall; Viet-Thi Tran; Andrea Cipriani · Research
What Are the Most Important Side Effects of Antidepressants According to Patients and Healthcare Providers?
A large international study reveals key differences between how patients and doctors rank antidepressant side effects
Source: Chevance, A., Tomlinson, A., Ravaud, P., Touboul, S., Henshall, C., Tran, V. T., & Cipriani, A. (2022). Important adverse events to be evaluated in antidepressant trials and meta-analyses in depression: a large international preference study including patients and healthcare professionals. Evidence-Based Mental Health. https://doi.org/10.1136/ebmental-2021-300418
What you need to know
- Patients and healthcare providers often rank the importance of antidepressant side effects differently
- The most concerning side effects for patients were insomnia, anxiety, and fatigue
- Healthcare providers were most concerned about sexual dysfunction, weight gain, and erectile problems
Understanding Side Effects Matter
When starting antidepressant medication, one of the biggest concerns for both patients and doctors is dealing with potential side effects. While some side effects may be minor inconveniences, others can significantly impact quality of life and whether someone continues taking their medication. But here’s the challenge - patients and healthcare providers don’t always see eye to eye on which side effects matter most.
What the Research Found
This large international study surveyed over 1,600 patients from 44 countries and 281 healthcare providers to understand how they ranked different antidepressant side effects. The results showed some interesting differences in perspective:
For patients, the most troublesome side effects were:
- Insomnia (difficulty sleeping)
- Anxiety
- Fatigue
- Weight gain
- Agitation
- Sexual problems
Meanwhile, healthcare providers ranked these as most important:
- Sexual dysfunction
- Weight gain
- Erectile problems
- Sleepiness
- Agitation
- Nausea
Beyond the Common Side Effects
Through open-ended questions, the researchers also uncovered important side effects that aren’t typically included in medication trials, such as:
- Emotional numbing - feeling disconnected from both positive and negative emotions
- Difficulty concentrating
- Increased irritability
- Withdrawal symptoms when stopping medication
As one patient described the emotional numbing: “It had not improved my depression; it had removed my ability to feel sadness (or happiness). This emotional flatness has persisted.”
Communication Gaps
The study revealed that about 16% of patients changed or stopped their antidepressants without consulting their doctor due to side effects. Some patients reported feeling unheard when trying to discuss certain side effects, particularly sexual dysfunction and emotional numbing, with their healthcare providers.
What This Means for You
If you’re taking or considering antidepressants, remember:
- Be open with your healthcare provider about which potential side effects concern you most
- Don’t hesitate to bring up any side effects you experience, even if they seem minor
- Never stop or change your medication without consulting your provider
- If you feel your concerns aren’t being heard, consider seeking a second opinion
Conclusions
- Side effects that matter most can differ significantly between patients and healthcare providers
- Open communication about side effects between patients and providers is crucial for successful treatment
- More comprehensive reporting of side effects in clinical trials is needed to better inform treatment decisions