Doctors Unaware of Many Patient Side Effects
Bothersome side effects are one reason people with depression stop taking their depression medications prematurely. Working with your doctor may help reduce these problems. But according to a recent study published in the Journal of Clinical Psychiatry, psychiatrists may not be aware of most side effects experienced by patients.
According to the study, the average number of side effects reported by people with depression was 20 times higher than the number recorded by psychiatrists. After the doctor office visit, patients completed a side effects checklist (an adapted version of the Toronto Side Effects Scale) in the waiting room and reported how often they experienced 31 possible medication side effects, such as nausea and dry mouth, and rated how troublesome these symptoms were.
Even when the list was narrowed to the most troubling side effects, the number of side effects reported by patients was still two to three times higher.
There are several possible explanations for these findings. Some of the symptoms could be attributed to depression rather than to medications, so the doctors didn't record them. It's also possible that some of the side effects might be due to medications for other conditions.
The researchers assert that it's more helpful for doctors to ask about specific side effects than to ask a global, open-ended question, such as, "Are you experiencing any problems related to your medication?" A side effects checklist for patients might also be beneficial.
The study involved 300 people—211 women and 89 men—with major depression being treated in the Rhode Island Hospital Department of Psychiatry, a private, outpatient practice. Most patients had medical insurance.
The majority of patients were taking two or more psychiatric medications; and more than one quarter were taking three or more medications. The most frequently prescribed medications were selective serotonin reuptake inhibitors (SSRIs) (57%), benzodiazepines (30%), serotonin and norepinephrine reuptake inhibitors (SNRIs) (24%), and bupropion (19%). Most patients were in the continuation or maintenance phase of depression treatment.
The bottom line: Premature discontinuation of depression medication is associated with poorer outcomes. While you should expect your doctor to ask about medication side effects, it's also your responsibility to tell your doctor about troublesome reactions—particularly if they cause you to take your medication less often or to stop taking it. Often, there are ways to reduce or manage side effects, such as switching to another depression medication within the same drug class. Talk to your doctor about the options.
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