ABSTRACT
In this chapter, the common and uncommon but serious side effects of antidepressants are reviewed. A primary problem has been the lack of correspondence between patient reports of side effects and those reported by psychiatrists and other prescribers, where patient complaints are at least 20 times greater. Another focus will be on the risks of falls and fractures, as well as SSRI-induced gastrointestinal bleeding and an increased liability for stroke in women taking SSRIs. The use of antidepressants in pregnancy will be reviewed. While the absolute rate of fetal malformations is low, a few SSRIs may confer additional risks. Moreover, some have found adverse events in infants born to mothers taking SSRIs. Finally, studies will be reviewed that indicate a risk of abnormal motor movements with SSRIs. An umbrella review in 2019 found no absolute contraindication to the use of antidepressants, but the data indicated a number of relative risks, some of which are serious. Studies on SSRIs and bleeding have been marred in some instances by significant methodological problems.
