Project details

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Adverse side-effects of antidepressants: are all patients at the same risk?

Keywords:
antidepressants Personalized medicine adverse side effects

Researchers:
Prof. dr. M.Y. Berger
dr. H. Burger
prof. dr. R.A. Schoevers
S.M. van Belkum
prof.dr. ND Scherpbier

Type of project:
Stage Wetenschap / Research project

Nature of the research:
Prospective cohort study

Fields of study:
GP medicine psychiatry

Background / introduction
Over 1 million Dutch people currently get an antidepressant prescribed, with depression as the main indication. Although the effectiveness of antidepressant medication (AD) in the treatment of depression is well-established, long-term AD use also results in several adverse side effects. They include sexual dysfunction, emotional flattening, dry mouth, headache, weight gain, increased autonomic tone and metabolic dysregulation. These adverse side effects are not only disturbing to the patient, they are also associated with treatment failure by discontinuation of AD, including Selective Serotonin Reuptake Inhibitors (SSRI’s).
Therefore, it is key to know which type of patients are at risk of adverse side effects in particular, as to be able to provide optimally personalized treatment for depression. Yet, the determinants of adverse side effects of AD remain poorly understood. In this project we will investigate in a large cohort of SSRI users (N ~ 600) who participated in the Optimal, PERsonalized Antidepressant (OPERA) study whether there are subgroups of patients with an increased risk of adverse side effects.
Research question / problem definition
What are demographic and clinical determinants of an increased risk of adverse side effects among long term users of SSRI’s?
Workplan
1. Understand the study OPERA study on the course of depression in a naturalistic cohort of adults with depression who started with antidepressants (citalopram or sertraline) at most two years before inclusion and perform some exploratory data analyses.
2. Formulate hypotheses in line with the research question and based on literature
3. Define determinants and outcomes and create a database for the analyses
4. Perform the analyses with help of a senior epidemiologist
5. Write the report
References
Bet PM, Hugtenburg JG, Penninx BW, Hoogendijk WJ. Side effects of antidepressants during long-term use in a naturalistic setting. Eur Neuropsychopharmacol. 2013;23(11):1443-51.
Reichenpfader U, et al. Sexual dysfunction associated with second-generation antidepressants in patients with major depressive disorder: results from a systematic review with network meta-analysis. Drug Saf. 2014;37(1):19-31.
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