Andidepressants Have 20 Times More Side Effects Than Recorded

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A new study from Rhode Island Hospital has found that patients who take medication for depression have 20 times more than psychiatrists have actually recorded in the charts.

One of the main reason patients discontinue their medication to treat depression is the side effects that they experience. This premature discontinuation of medication is also associated with poor treatment outcomes.

In his recent study, lead researcher Mark Zimmerman, MD, director of outpatient psychiatry at Rhode Island Hospital, makes note that despite the clinical importance of detecting side effects, there are very few studies that are willing to examine the detection and documentation methods currently in use among clinicians.

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Zimmerman and his team of researchers asked 300 patients in treatment for depression to complete a self-administered version of the Toronto Side Effects Scale (TSES). The patients rated the frequency of the 31 side effects and the degree of trouble they experienced. Those patients' charts were then examined to extract side effects information recorded by the treating psychiatrist.

Researchers were surprised when they discovered that the number of side effects reported by the patients on the TSES was 20 times higher than the number recorded by the psychiatrist. When the self-reported side effects were limited to "frequently occurring" or "very bothersome" the rate was still found to be two to three times higher than recorded in their charts.

Zimmerman, also an associate professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University, says, "Despite the importance that side effects have on premature medication discontinuation, there is some evidence that clinicians may not do a thorough job of eliciting information regarding their presence. This study finds that clinicians do not record in their progress notes most side effects reported on a side effects questionnaire."

Zimmerman says, "As a result of this study, we believe that ongoing dialogue about side effects during treatment will help to reduce premature medication discontinuation and would help reduce depression relapse rates. Incorporating a self-report questionnaire like the TSES may be helpful to adopt into clinical practice for the treatment of depression."

For now, researchers recommend the use of a self-administered patient questionnaire in clinical practice to improve the recognition of side effects for patients in treatment.

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