Subtle psychological side effects: documentation, description, and treatment implications of subjective experiences of selective serotonin reuptake inhibitors taken for depression
Psychological side effects may affect patients' willingness to continue or return to SSRI treatment, and may be one reason for client dissatisfaction with medication. The goal of this study was to document the existence of a range of psychological side effects associated with SSRIs taken for depression and to determine their relationship to patients' decisions to stop treatment, and attitudes toward taking SSRIs again. Methods. We conducted 161 semi-structured telephone interviews of adults who had completed a course of treatment for depression with one of the SSRIs. We elicited information about drug effects on symptoms, physical side effects, unwanted psychological effects, reasons for quitting and willingness to return to the same treatment in case of future depression. We identified 29 categories of unwanted psychological effects and analyzed data in terms of Responders and Non-Responders, the former split into Renewers and Non-Renewers. Results. Contrary to expectations, Non-Renewers and Non-Responders did not differ in the number of SEs experienced, and Non-Responders experienced significantly more unwanted psychological effects than either Renewers or Non-Renewers, t (121) = 2.818, p < .01. Twenty-seven percent of the sample cited psychological side effects and 27% cited physical side effects as primary reason for quitting SSRI treatment. Non-Responders cited psychological side effects rather than non-response as their primary reason for quitting, and Non-Renewers cited physical more than psychological side effects. Conclusion. Psychological side effects might well be included in measures and discussions of side effects, even though they present no known physical danger to the patient. Discussion. Unwanted psychological effects reported by our participants included problems with empathy, sociability, irritability, and creativity. These are interpreted as supporting a contextualist or developmental view of psychopathology. A thoroughly contextualized approach to treatment is therefore recommended.
- Psychology