The Pharmaceutical Journal
Vol 273 No 7319 p456
2 October 2004

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Pharmacists can identify SSRI patients at risk

Pharmacists, as well as physicians and other health care practitioners, can help identify patients at risk of adverse effects from selective serotinin reuptake inhibitors in the treatment of depression. Associate professor Jay Cohen, University of California, writes that initial evaluations for SSRIs should look at size, age, concomitant medication and history.

Writing about the controversies involving potential side effects of SSRIs, he suggests that dosing may be to blame. He describes a patient who became psychotic on a 20mg fluoxetine dose who subsequently “did very well” on a 5mg dose.

Questioning the recommended doses of these drugs, he comments on a “lack of precision” in how antidepressants in general are prescribed to individuals. He adds that practitioners fail to warn patients about possible anxiety, agitation or akathisia-like events with some agents.

He says that many patients welcome information about lower, safer, proven-effective doses of these agents and prefer to start with them (Annals of Pharmacotherapy 2004; 38:1743).