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Distressing Adverse Events After Antidepressant Switch in the Sequenced Treatment Alternatives to Relieve Depression ( STAR *D) Trial: Influence of Adverse Events During Initial Treatment with Citalopram on Development of Subsequent Adverse Events with an Alternative Antidepressant
Author(s) -
Katz Aaron J.,
Dusetzina Stacie B.,
Farley Joel F.,
Ellis Alan R.,
Gaynes Bradley N.,
Castillo Wendy C.,
Stürmer Til,
Hansen Richard A.
Publication year - 2012
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.2011.01020.x
Subject(s) - venlafaxine , citalopram , adverse effect , sertraline , bupropion , depression (economics) , antidepressant , medicine , major depressive episode , major depressive disorder , confidence interval , confounding , psychiatry , anxiety , mood , macroeconomics , pathology , smoking cessation , economics
Study Objective To determine whether distressing adverse events ( DAE s) experienced during initial antidepressant treatment are associated with subsequent DAE s after switching to a second antidepressant. Design Secondary analysis of data from the Sequenced Treatment Alternatives to Relieve Depression ( STAR *D) trial. Setting Primary care and psychiatric care facilities. Patients A total of 727 outpatients aged 18–75 years with nonpsychotic major depressive disorder who failed first‐step therapy with citalopram and were switched to second‐step monotherapy with an alternative antidepressant. Measurements and Main Results In the STAR *D trial, patient‐reported DAE s were entered into the Patient‐Rated Inventory of Side Effects ( PRISE ). In this secondary analysis, data from PRISE were used to determine the incidence of DAE s during first‐step treatment with citalopram and second‐step treatment with sustained‐release bupropion, sertraline, or extended‐release venlafaxine. Regression models were used to compare the risk of adverse events during second‐step treatment between those who reported similar adverse events during first‐step treatment and those who did not, while controlling for potential confounders. Of the 727 patients analyzed, DAE s were reported by 514 patients (70.7%) during first‐step treatment and 626 (86.1%) during second‐step treatment; no significant differences were observed among the three second‐step treatment groups. Overall, patients reporting DAE s during first‐step treatment were more likely to report DAE s during second‐step treatment (risk ratio [ RR ] 1.11, 95% confidence interval [ CI ] 1.03–1.20). After controlling for confounders, patients were significantly more likely to report DAE s specific to a body function or organ system, such as those involving the genitourinary system ( RR 3.39, 95% CI 2.41–4.78) or sexual functioning ( RR 2.75, 95% CI 2.29–3.29), if the patients had reported similar events during initial treatment. Conclusion Patients who experienced DAE s with initial antidepressant treatment were likely to report similar adverse events after switching to an alternative antidepressant, even when subsequent treatment is from a different class of antidepressants.