We present an 81-year-old male patient treated with sertraline and furosemide who presented with a recent-onset symptomatic hyponatremia. Low sodium levels persisted for more than 1 week after furosemide had been discontinued. [ncbi.nlm.nih.gov]

This review attempts to present the current status of these add-on/combination approaches with particular focus on the medicinal chemistry aspects. [doi.org]

• Weight Gain

  Not surprisingly, the first drugs designed to affect serotonin levels often caused side effects of drowsiness, weight gain, and nausea. [anxiety.org]

  Sexual dysfunction may occur at higher doses but there appears to be low risk of weight gain and sedation. There is still much to learn about this drug, particularly whether it has unique characteristics in comparison to existing antidepressants. [ncbi.nlm.nih.gov]

  Infant colic, GI symptoms, a seizure-like episode and poor weight gain have all been reported (Chambers et al., 1999). However, most of the infants do well. [web.archive.org]

• Weight Loss

  […] and weight loss or stabilization [III]. [web.archive.org]

  However: appetite reduction and weight loss most likely with fluoxetine. possible weight gain with some other SSRIs. SSRIs have been used to treat bulimia (compulsive eating). The effect on sleep is unpredictable. [bluepages.anu.edu.au]

  Common side effects Common side effects of SSRIs can include: feeling agitated, shaky or anxious feeling or being sick indigestion diarrhoea or constipation loss of appetite and weight loss dizziness blurred vision dry mouth excessive sweating sleeping [nhs.uk]

  loss or weight gain Taking your medication with food may reduce the risk of nausea. [mayoclinic.org]

• Epilepsy

  – SSRIs should only be taken if your epilepsy is well controlled, and they should be stopped if your epilepsy gets worse narrow angle glaucoma serious kidney, liver or heart problems SSRIs may need to be used with caution or not at all if you have one [nhsinform.scot]

  – SSRIs should only be taken if your epilepsy is well controlled, and the medication should be stopped if your epilepsy gets worse narrow angle glaucoma serious kidney, liver or heart problems SSRIs may need to be used with caution or not at all if you [nhsdirect.wales.nhs.uk]

  SSRIs also need to be used with caution if you have certain underlying health problems, including diabetes, epilepsy and kidney disease. [nhs.uk]

  Epilepsy - there is the need to weigh up the risks and benefits; avoid if poorly controlled and discontinue if there is deterioration; seek specialist advice if necessary. [patient.info]

• Chills

  In some stories causation is acknowledged and the juxtaposition of these stories with those where it goes unrecognized as well as the repetition of themes and circumstances is chilling. [web.archive.org]

  GI symptoms, 'chills', insomnia, hypomania, anxiety and restlessness may occur. Aim to reduce the dose gradually over about four weeks or so to try to avoid/ameliorate this. [patient.info]

  People taking SSRIs who notice unusual joint or muscle pain; breathing problems; chills or fever ; excessive excitement, fast talking, or actions that are out of control; or mood swings should contact their doctors. [medical-dictionary.thefreedictionary.com]

  Serotonin reuptake inhibitors should not be abruptly discontinued after extended therapy, and whenever possible, should be tapered over several weeks to minimize discontinuation-related symptoms which may include nausea, headache, dizziness, chills, body [en.wikipedia.org]

• Collapse

  After collapsing for genotype, this group consisted of at least 20 mice per treatment. [dx.doi.org]

  These collapsed ordinal scales are referred to later as suicide risk measures. [doi.org]

  As these widely used drugs were found to be highly addictive, it looked as if a substantial market was about to collapse. Hundreds of thousands of people took these drugs and the economic gains were enormous. [guardian.co.uk]

• Abdominal Pain

  However, there was no improvement in abdominal pain (RR = 2.29; 95% CI, 0.79 to 6.68; 197 patients) or in overall symptom score (summary measure of abdominal pain, diarrhea, and constipation [RR = 1.36; 95% CI, 0.81 to 2.27; 72 patients]). 1 A second [aafp.org]

  An older woman presented to the hospital with abdominal pain and subsequently had three episodes of melaena, requiring blood transfusions. She was known to suffer with severe depression and was on high-dose fluoxetine. [ncbi.nlm.nih.gov]

  In the Emslie 2009 trial, abdominal pain, nausea, vomiting and dizziness were reported more often in the escitalopram group; headache, abdominal pain, diarrhoea, pharyngitis and rhinitis were reported in both groups ( Table 4 ). [doi.org]

  CLINICAL EFFECTS 9.1 Acute poisoning 9.1.1 Ingestion Nausea, vomiting, abdominal pain, diarrhea, tremor, confusion, agitation, drowsiness, blurred vision, and in rare cases, seizures and coma. [inchem.org]

• Abdominal Cramps

  Side effects Common side effects include: mild nausea and vague headache which usually clear after a few days of use diarrhoea and abdominal cramping pain agitation and physical restlessness reduced sex drive and difficulty reaching an orgasm The effect [bluepages.anu.edu.au]

  cramping, nausea, and diarrhea. [emedicine.medscape.com]

  cramps 2 out of 73 No serious adverse event 0 out of 65 CIT-MD-03, 2005 Citalopram 2 congestive heart failure, 1 cerebro vascular accident, 1 hyponatremia 4 out of 84 1 cerebro vascular accident, 1 cellulitis 2 out of 90 29060/810 (A), 2005 Paroxetine [dx.doi.org]

• Palpitations

  The most common adverse effects included nausea, hyperhidrosis, constipation, tachycardia, palpitations, erectile dysfunction and ejaculation disorder. [doi.org]

  Monitoring of serum magnesium is advised, particularly in elderly patients, who may be taking diuretics or proton pump inhibitors if cardiovascular symptoms, such as palpitations, vertigo, syncope, or seizures develop during treatment, cardiac evaluation [mhra.gov.uk]

  The SSRI, fluvoxamine, is also known to enhance the effects of caffeine, so people who drink large amounts of caffeine may experience unpleasant symptoms such as palpitations, feeling sick, restlessness and insomnia. [nhsinform.scot]

  Effects of caffeine that may be exaggerated while taking fluvoxamine include insomnia (trouble sleeping), feeling anxious or agitated, or having heart palpitations (an awareness of your heart beating quickly in your chest). [mydr.com.au]

  Palpitations, flushes, and arrhythmias are also possible adverse drug reactions. Gastrointestinal effects: Constipation, dry mouth, anorexia, weight gain or loss, and nausea are some common adverse effects of SSRIs. [goodtherapy.org]

• Bruxism

  Ten isolated cases of bruxism were identified. Ten additional reports could not be classified. [ncbi.nlm.nih.gov]

  Other sources state that reports of selective serotonin reuptake inhibitors causing bruxism are rare, and it only happens with long-term use. The story about medication (selective serotonin reuptake inhibitors in particular) is more controversial. [fr.bab.la]

  Brain 110: 761 - 766 Google Scholar | Crossref | Medline | ISI Romanelli F., Adler DA, Bungay KM ( 1996 ) Possible paroxetine-induced bruxism. [doi.org]

  Early / 1.0-3.0 palpitations / Early / 2.0-3.0 dysuria / Early / 0.1-3.0 amnesia / Delayed / 0.1-2.0 memory impairment / Delayed / 2.0-2.0 hypertension / Early / 1.0-2.0 sinus tachycardia / Rapid / 1.0-2.0 myopathy / Delayed / 0-2.0 teeth grinding (bruxism [pdr.net]

• Blurred Vision

  Some of the more commonly reported side effects include: Blurred vision Dizziness Drowsiness (fluoxetine is more likely to cause insomnia ) Dry mouth Gastrointestinal upset (such as constipation, diarrhea, or nausea ) Headache Sexual dysfunction (such [drugs.com]

  While most side effects first occurred within the first 2 weeks of treatment, the majority of patients were still experiencing the same side effects at the time of interview, most notably blurred vision (85%) and sexual dysfunction (83%). [dx.doi.org]

  Common side effects of SSRIs can include: feeling agitated, shaky or anxious feeling or being sick dizziness blurred vision low sex drive difficulty achieving orgasm during sex or masturbation in men, difficulty obtaining or maintaining an erection [nhs.uk]

• Loss of Libido

  Dizziness Blurred vision Loss of libido and erectile dysfunction With time, many of the less serious side effects of SSRI therapy may improve. [news-medical.net]

  Common side effects of SSRIs can include: feeling agitated, shaky or anxious diarrhoea and feeling or being sick dizziness blurred vision loss of libido (reduced sex drive) difficulty achieving orgasm during sex or masturbation in men, difficulty obtaining [nhs.uk]

  Others never find adequate relief, or they experience annoying side effects—such as mania, insomnia, emotional flatness or loss of libido—so they keep trying different drugs, often in combination with psychotherapy. [blogs.scientificamerican.com]

  But even though their side effects are more benign, SSRIs can still cause nausea, diarrhea, headaches, loss of libido, and tremors. All of these symptoms disappear, however, after about the first month of use. [thebrain.mcgill.ca]

• Agitation

  Symptoms of serotonin syndrome can include: confusion agitation muscle twitching sweating shivering diarrhoea If you experience these symptoms, you should stop taking the medication and seek immediate advice from your GP or specialist. [nhs.uk]

  Prominent features of the delirium, which lasted for nearly 2 days, included agitation, confusion, uncontrolled limb movements, abnormal ocular function, hypertension, pyrexia, brisk reflexes, ankle clonus and raised creatine kinase. [ncbi.nlm.nih.gov]

  Nausea, insomnia, headaches, sexual difficulties, initial agitation. Fluoxetine (Prozac) Possible Benefits. Helpful for depression, panic disorder, social anxiety, obsessive compulsive disorder, generalized anxiety and PTSD. [anxieties.com]

• Seizure

  The incidence of seizures was 1.9% and coma was 2.4%. Serotonin syndrome occurred in 14% of overdoses. [ncbi.nlm.nih.gov]

• Tremor

  Symptoms include agitation, confusion, sweating, tremors, and a rapid heart rate An increase in the risk of bleeding, especially if used with other medications that also increase bleeding risk. [drugs.com]

  Headache, dry mouth, sleepiness, dizziness, tremors, diarrhea, agitation, confusion, nausea, delayed ejaculation in men. Dosages Recommended by Investigators. Start with 50 mg in morning or evening. Maximum dose is 200 mg. Taper slowly. [anxieties.com]

  Clinical signs are dose dependent and higher dosages may result in the serotonin syndrome that manifests itself as ataxia, tremors, muscle rigidity, hyperthermia, diarrhea, and seizures. [ncbi.nlm.nih.gov]

• Mild Cognitive Impairment

  Sun et al. reported that in Taiwan, the age-adjusted prevalence of all-cause cognitive impairment, which includes mild cognitive impairment (MCI) or very mild dementia (VMD), was 8.04% (95% confidence interval (CI): 7.47–8.61) [ 1 ]. [dx.doi.org]

Withdraw treatment plus preventive medication may lead to a better outcome. [ncbi.nlm.nih.gov]

The prognosis in animals that receive treatment is excellent. In one retrospective study, there were no deaths in 313 SSRI-poisoned dogs. No characteristic or classic histopathologic lesions result from SSRI toxicosis. [ncbi.nlm.nih.gov]

9.1.1 Ingestion 9.1.2 Inhalation 9.1.3 Skin exposure 9.1.4 Eye contact 9.1.5 Parenteral exposure 9.1.6 Other 9.2 Chronic poisoning 9.2.1 Ingestion 9.2.2 Inhalation 9.2.3 Skin exposure 9.2.4 Eye contact 9.2.5 Parenteral exposure 9.2.6 Other 9.3 Course, prognosis [inchem.org]

Depression and 18-month prognosis after myocardial infarction. Circulation. 1995; 91 : 999–1005. Crossref Medline Google Scholar 4 Musselman DL, Evans DL, Nemeroff CB. [circ.ahajournals.org]

Understanding of the etiology of depression has been hampered by the absence of direct measurements of monoamines in humans. [ncbi.nlm.nih.gov]

[…] access through Ovid Abstract There is some evidence that major depression-in particular, treatment-resistant depression (TRD)-is accompanied by activation of the inflammatory response system and that proinflammatory cytokines may play a role in the etiology [dx.doi.org]

Use of over-the-counter medications or dietary supplements in addition to prescribed serotonergic medications is also an important etiology. [emedicine.medscape.com]

The first epidemiological study was published in 1999 and since then, 34 epidemiological studies from different areas, most of them including elderly patients in their study populations, have been published with a variety of results. [ncbi.nlm.nih.gov]

Abstract The monoamine hypothesis of depression predicts that the underlying pathophysiologic basis of depression is a depletion in the levels of serotonin, norepinephrine, and/or dopamine in the central nervous system. [ncbi.nlm.nih.gov]

It is unclear whether antidepressants can prevent suicides or suicide attempts, particularly during long-term use. The Authors carried out a comprehensive review of long-term studies of antidepressants (relapse prevention). [prn.fm]

Authors' conclusions: Since the last version of this review, the new included studies have not added high quality evidence to support the use of SSRIs or venlafaxine as preventive drugs for migraine. [cochrane.org]

SSRIs prevent serotonin from being removed from the space between brain cells. [sharecare.com]

Withdraw treatment plus preventive medication may lead to a better outcome. [ncbi.nlm.nih.gov]

Preventive Services Task Force. Screening for osteoporosis: US preventive services task force recommendation statement. Ann. Intern. Med. 154(5), 356–364 ( 2011 ). Crossref, Medline, Google Scholar 25 Eom C-S, Lee H-K, Ye S, Park SM, Cho K-H. [dx.doi.org]