Adverse effects of antidepressants and monitoring practices in adult patients at a psychiatric outpatient department of Tikur Anbessa Specialized Hospital: a cross-sectional study

Abstract

Abstract Background Available studies showed that antidepressants (ATDs) and antipsychotics are most frequently associated with adverse effects (AEs), which account for ~90% of all AEs in the psychiatry department. These AEs can range from mild to serious or potentially lethal events and pose a significant threat to the physical and mental well-being of patients leading to decreased quality of life, reduced drug adherence, and increased healthcare costs. Objective This study aimed to assess the prevalence of self-reported ATD-related AEs among patients attending the psychiatric outpatient department (OPD) at Tikur Anbessa Specialized Hospital (TASH), Ethiopia, and examine current monitoring practices and corrective measures undertaken. Method A hospital-based cross-sectional study was conducted in the psychiatric OPD of TASH from 1 April 2023 to 30 May 2023. Descriptive analysis was done to summarize the quantitative data. Logistic regression analysis was performed to identify predictors of occurrence of ATD-related AEs. Results The overall prevalence of self-reported ATD-related AEs was 51.3%. The two most reported classes of ATDs were selective serotonin reuptake inhibitors (52.8%) and tricyclic ATDs (47.2%). Across all the utilized ATDs, sedation (46.2%), dry mouth (31.4%), constipation (21.8%), and sexual dysfunction (18.6%) were the most frequently exhibited AEs. Alas, roughly 60.3% of patients have never been asked by healthcare providers about their AEs. When AEs occurred, only 21.2% of patients consulted healthcare professionals for genuine guidance and support. Old age (odds ratio (OR) = 2.84, 95% confidence interval (CI) 1.09–7.40), duration of treatment of >1 year (OR = 2.17, 95% CI 1.07–4.43), daily ingestion of more than five pills (OR = 3.82, 95% CI 0.99–14.76), presence of asthma (OR = 3.45, 95% CI 1.02–11.68), and taking other psychotropic agents (OR = 2.92, 95% CI 1.40–6.07) were significantly associated with the occurrence of ATD-related AEs. Conclusion This study unveiled a high prevalence of AEs among patients taking ATDs. Advanced age, long treatment duration, daily ingestion of more than five pills, presence of asthma, and taking other psychotropic medications were predictors of ATD-related AE occurrence.