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Treatment-emergent behavioural
side effects with selective serotonin re-uptake inhibitors in adults
with learning disabilities.
Biswas AB, Bhaumik S,
Branford D.
University of Leicester, & Leicestershire and
Rutland Healthcare NHS Trust, Frith Hospital, Groby Road, Leicester LE3
9QF, UK.
Selective serotonin re-uptake inhibitors are widely used
for the treatment of depression suffered by adults with learning
disabilities. However, the presentation, time of onset and prevalence of
treatment emergent symptoms, have not been extensively studied in adults
with learning disabilities. The aim of this study was to determine these
aspects of treatment. The study design involved retrospective analysis
of case notes of all adults with learning disabilities treated with
either fluoxetine or paroxetine for depression. During 31% of treatment
episodes, patients suffered treatment emergent symptoms during treatment
with either selective serotonin re-uptake inhibitor (SSRI). These
symptoms subsided on discontinuation of the SSRI. The common emergent
symptoms in this group were elevated mood (39%), decreased sleep (35%),
hyperactivity (30%), overtalkativeness (26%), agitation (24%) and
aggression (37%). In 20% symptoms developed within 1 month and in 67%
within 7 months of starting treatment with a SSRI. There were no
significant differences noted in the frequency and nature of treatment
emergent symptoms between fluoxetine and paroxetine. Few guidelines, if
any, exist for initiating and continuing antidepressant treatment for
therapeutic or prophylactic use in this patient population. Close
monitoring of efficacy and tolerability, including treatment emergent
psychiatric symptoms is warranted. Copyright 2001 John Wiley & Sons,
Ltd.
PMID: 12404583 [PubMed - as supplied by publisher]
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