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Layout Element Antidepressant Medications
 

Handout IconHandout: Managing Antidepressant Side Effects (52k PDF)

Side Effect

Response

Risk of Seizure •  Use SSRIs or bupropion cautiously in patients at risk for seizures.
•  Avoid concomitant medications that lower the seizure threshold while patient is on bupropion.
•  Do not exceed bupropion 150 mg as a single dose.
•  Do not exceed bupropion 400 mg/day.
•  Use gradual dose titration when using bupropion.
Headache, nervousness, agitation •  Associated with SSRI use.
•  Subsides after 1 - 2 weeks in most cases.
•  Advise to call if they do not subside, then adjust dose or change therapy.
Nausea •  Subsides after 1 - 2 weeks in most cases.
•  Advise to take after meals.
•  Adjust dose.
Sexual side effects •  Switch medications from one SSRI to another, or to another antidepressant from a different class, such as bupropion.
Insomnia •  Advise patient to take the medication once daily in the morning if on an SSRI.
•  Consider switching to venlafaxine or mirtazipine since they have sedating effects.
•  Investigate other possible causes, such as pain, sleep apnea, restless leg syndrome, interferon, or poor sleep hygiene.
•  Consider treating insomnia with medication, for example trazodone, temazepam, or zolpidem.
Sedation •  Advise taking mirtazipine or venlafaxine at bedtime.
•  Advise taking at bedtime if the SSRI is causing sedation.
 
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