Complications
May be an adverse effect of some antidepressants.[129] Patients can be switched to an alternative antidepressant.
Most patients with persistent depressive disorder have comorbid psychiatric conditions, which are treated accordingly.
Most patients with persistent depressive disorder have comorbid psychiatric conditions, which are treated accordingly.
Sexual adverse effects are common with various antidepressant medications, and may be under-reported; they may reduce medication adherence. Management includes watchful waiting, decreasing antidepressant dose, medication augmentation, use of sildenafil or related medications, and other strategies.[131]
The suicide rate for patients with persistent depressive disorder is unknown, but is likely to be higher than for the general population because persistent depressive disorder has a chronic and often unremitting course. Selective serotonin reuptake inhibitors have been associated with increased suicidal thinking, particularly in adolescents.[83][130] Patients should be monitored closely for changes in behavior and/or the emergence of suicidal thinking.
Significant effects in blood pressure are uncommon with newer antidepressants. They are more common with tricyclic antidepressant and monoamine oxidase inhibitors which can lead to orthostatic hypotension. Of newer antidepressants, serotonin-noradrenaline reuptake inhibitors such as duloxetine can increase blood pressure.
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