Depression - Side effects (general)

Question 1

St. John’s Wort

Answer 1

Herbal remedy used for depression.
NOT recommended
Enzyme inducer
Interacts with many drugs, including antidepressants

Question 2

Hyponatraemia

Answer 2

Risk with all antidepressants - most common with SSRIs
Typically in elderly
Hyponatraemia should be considered in all pts with:
- drowsiness
- confusion
- convulsions

Question 3

Suicidal behaviour or ideation

Answer 3

Children, young adults and patients with a history of suicidal behaviour.
Monitor for suicidal behaviour, self-harm or hostility.
Particularly at start of treatment/dose change.

Question 4

Serotonin syndrome

Answer 4

Uncommon ADR
Symptoms can be life-threatening
Divided into 3 areas:

1. Neuromuscular hyperactivity (tremor, hyperreflexia, clonus, myoclonus, rigidity)
2. Autonomic dysfunction (tachycardia, BP changes, hyperthermia, diaphoresis, shivering, diarrhoea)
3. Altered mental state (agitation, confusion, mania)