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 Handout:
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.
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| Sedation |
• Advise taking mirtazipine or venlafaxine at bedtime.
• Advise taking at bedtime if the SSRI is causing sedation.
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