antidepressants

Side Effects of Antidepressants

Tricyclic Antidepressants: Side Effects

  • Fatigue
  • Sedation
  • Slow psychomotor reactions
  • Poor concentration
  • Tremors
  • Ataxia
  • Suicidal gestures
  • Anticholinergic effects:
    • Dry mouth
    • Decreased tearing
    • Blurred vision (common)
  • Other effects:
    • Constipation
    • Urinary hesitancy or retention
    • Excessive sweating

Selective Serotonin Reuptake Inhibitors (SSRIs): Side Effects

  • Dry mouth
  • Nausea
  • Diarrhea
  • Drowsiness
  • Dizziness
  • Nervousness
  • Sweating
  • Headaches
  • Insomnia

Selective Serotonin/Norepinephrine Reuptake Inhibitors (SSNRIs): Side Effects

  • Increased blood pressure
  • Weakness
  • Sweating
  • Sleepiness
  • Dry mouth
  • Nausea
  • Vomiting
  • Constipation
  • Anorexia
  • Blurred vision
  • Anxiety
  • Tremors

Other Antidepressants: Side Effects

  • Dizziness
  • Drowsiness
  • Anxiety
  • Confusion
  • Tremors
  • Weakness
  • Dry mouth
  • Nausea
  • Diarrhea
  • Increased appetite
  • Paralytic ileus
  • Urinary retention
  • Orthostatic hypotension
  • Tachycardia
  • Palpitations

Monoamine Oxidase Inhibitors (MAOIs): Side Effects

  • Increased CNS (Central Nervous System) stimulation
  • Postural hypotension
  • Muscle twitching
  • Fluid retention
  • Urinary hesitancy
  • Insomnia
  • Food-drug interaction with tyramine (common amino acid)

Nursing Care for Antidepressants

  • Administration Practices:

    • Give medications at bedtime.
    • Increase doses slowly to monitor responses.
    • Teach caution when using machinery due to potential effects.
    • Document patient behaviors following medication.

  • Suicide Precautions:

    • Implement precautions due to drug-induced increases in energy that may elevate suicide risk.

  • Oral Care:

    • Encourage frequent oral hygiene, water intake, gum chewing; recommend artificial tears for dry eyes.
    • Ensure vision improves within 2 weeks and report any eye pain immediately.

  • Diet and Fluid Intake:

    • Monitor food and fluid intake, promoting a high-fiber diet of more than 30 mg/day.
    • Encourage at least 2500 mL/day of fluid intake.
    • Teach the importance of adequate fluids, clothing choices, and sensible exercise.
    • Avoid hot showers and dehydration; monitor urinary output especially in older men.

  • General Patient Safety:

    • Maintain good hygiene; advise the use of cotton clothing and ensure fluid intake.
    • Teach relaxation techniques; provide mild analgesics as necessary.

  • Sleep Hygiene:

    • Administer medications early in the day; encourage good sleep habits and relaxation techniques.

  • Vital Sign Monitoring:

    • Monitor vital signs continuously; report to a physician if high blood pressure persists; may require a dosage reduction.

  • Mental Health Monitoring:

    • Ensure patient safety; monitor mental status, mood, affect, and consciousness levels.
    • Weigh the patient weekly and track any weight gain; encourage hydration of 2500 mL/day and monitor intake and output.

  • Rising Precautions:

    • Teach patients to rise slowly to prevent falls due to orthostatic hypotension; reassure that symptoms will diminish.

  • Additional Advice:

    • Administer Vitamin B6 (300 mg/day) which is indicated to be helpful.
    • Monitor intake and output consistently; administer thiazide diuretics as needed according to orders.
    • Give the last dose of the day as early as possible; promote relaxation at night.
    • Strictly avoid tyramine-rich foods and drugs containing epinephrine or stimulants.