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Author: Admin | 2025-04-28
Difficulties, abnormal ejaculation diarrhea headache nervousness insomnia agitation sweating dry mouth tachycardia anorexia increased appetite weight gain anxiety insomnia drowsiness While SSRIs do not appear to differ in overall tolerability, the reported incidences of specific side effects vary. Antidepressants have some different pharmacological characteristics, this means that patients may respond differently to certain SSRIs or experience different side effects with different drugs. Nausea The most common side effect associated with use of SSRIs is nausea. Paroxetine and sertraline have been associated with slightly more cases of nausea. Sexual dysfunction The SSRIs as a class produce a variety of sexual side effects, including anorgasmia, decreased libido, impotence, and delayed ejaculation. Analysis of the clinical trials suggests that fluvoxamine and fluoxetine are less likely to produce sexual side effects than paroxetine and sertraline. Paroxetine appears to cause the highest rate of sexual dysfunction. Citalopram has been associated with loss of libido and may be associated with a relatively higher level of sexual dysfunction compared with sertraline. The SSRIs are reported to cause sexual dysfunction in the following descending order of frequency: citalopram 72.7%; paroxetine 70.7%; sertraline 62.9%; fluvoxamine 62.3%; fluoxetine 57.7%28. Paroxetine produces more delay of orgasm or ejaculation than fluvoxamine, fluoxetine and sertraline 16. Weight gain Weight gain is another troubling side effect. The SSRIs vary in their effect on the weight. Paroxetine, fluoxetine, citalopram and sertraline have been shown to increase body weight after 6–12 months of therapy8. Fluoxetine and sertraline have the lowest incidence of weight gain during long-term treatment, paroxetine and citalopram higher17. Paroxetine may cause a significant weight increase, sertraline may cause modest but nonsignificant weight increase with long-term treatment15. Of the SSRIs, paroxetine may be responsible for the highest risk of weight gain9. Sertraline is generally associated with a small degree of weight loss in the acute phase of treatment. Fluoxetine has potent appetite suppressing effects and may cause modest but nonsignificant weight decrease15. Predictors for antidepressant-induced weight gain35: Family history of obesity (genetic factors) Lower levels of educational attainment Low body mass index at the beginning of antidepressant therapy Effects on sleep SSRIs interfere with
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