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The Psychoactive Effects of Antidepressants and their Association with Suicidality

Goldsmith, L; Moncrieff, J (2011) The Psychoactive Effects of Antidepressants and their Association with Suicidality. Current Drug Safety, 6 (2). pp. 115-121. ISSN 1574-8863 https://doi.org/10.2174/157488611795684622
SGUL Authors: Goldsmith, Lucy Pollyanna

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Abstract

Although antidepressants are known to produce some adverse mental effects, their full range of psychoactive effects has not been systematically described. It has been suggested that some antidepressants are associated with increased suicidal thoughts and actions, but the issue remains controversial, and the mechanism of association, if any, is unclear. In the current study we examined descriptions of the major psychoactive and physical effects experienced by users of two commonly used antidepressants, fluoxetine and venlafaxine, as reported on a patient-oriented web site. We categorised responses into common psychoactive effects and explored associations among those effects, including reported increases in suicidal ideation. In the 468 descriptions we examined, the most commonly reported drug-induced psychoactive effects were sedation, impaired cognition, reduced libido, emotional blunting, activation (feelings of arousal, insomnia and agitation) and emotional instability. There were no differences between the two drugs in the prevalence of reporting of these effects. Activation effects were associated with involuntary movements, suggesting a physical basis. Emotional blunting was associated with cognitive impairment, reduced libido and sedation. Emotional instability, which included the reported side effects of increased anxiety, anger, aggression and mood swings, was related to activation effects and was more commonly reported by younger respondents. Increased suicidal thoughts were rare but were associated with both types of emotional effect. The effects identified are consistent with other data, and suggest that some antidepressants may induce emotional effects that are experienced as unpleasant, may impact on the symptoms of mental disorders, and may account for the suggested occurrence of increased suicidal impulses in some users.

Item Type: Article
Additional Information: The published manuscript is available at EurekaSelect via http://www.eurekaselect.com/openurl/content.php?genre=article&doi=10.2174/157488611795684622
Keywords: Pharmacology & Pharmacy, 1115 Pharmacology And Pharmaceutical Sciences, 1103 Clinical Sciences, 1104 Complementary And Alternative Medicine
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Current Drug Safety
ISSN: 1574-8863
Dates:
DateEvent
1 April 2011Published
10 February 2010Accepted
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
UNSPECIFIEDWellcome Trusthttp://dx.doi.org/10.13039/100004440
URI: http://openaccess.sgul.ac.uk/id/eprint/108188
Publisher's version: https://doi.org/10.2174/157488611795684622

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