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David Baxter

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Concerns in Depression Treatment: Sexual Dysfunction and Weight Gain
Anita H. Clayton, MD, and Antonella Favit, MD, PhD
Primary Psychiatry, 2007;14(6):66-75

Focus Points

? Antidepressants are often associated with sexual dysfunction and weight gain.

? Clinicians should consider the risk for occurrence of these side effects when selecting an antidepressant.

Abstract
Premature discontinuation of antidepressants is a prevalent and significant problem in the treatment of major depressive disorder (MDD). When a patient discontinues an antidepressant without consulting the clinician, the possibility of full remission of an acute depressive episode is seriously compromised and risk for subsequent recurrent episodes is increased. The primary reason patients discontinue antidepressant therapy without informing clinicians is a side effect that the patient attributes to the medication. Because all antidepressants have both short- and long-term side effects, this problem is of major concern both for patients with established chronic MDD who need longer term maintenance treatment as well as for those who are initiating acute therapy. Long-term side effects are most challenging to both the patient and clinician, especially during maintenance therapy. Sexual dysfunction and weight gain are two side effects particularly burdensome to patients. They tend to be long-term, may worsen with continued treatment, and are likely to have a significant impact on the patient?s quality of life. One or both of these adverse events are commonly associated with most antidepressants. Long-standing needs related to these side effects include physician-patient commitment to early and ongoing communication and assessment, timely intervention, and awareness of management options as well as the development of new, more tolerable therapies.
 

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