Table 3.
Risk for specific adverse effects under treatment with the analyzed antidepressants.
| Drug (prediction interval) | Side effect | Risk ratio | 95%-CI | Evidence |
|---|---|---|---|---|
| Amitriptyline | Dry mouth | 3.14 | 1.10; 8.94 | ++ |
| Headache | 3.39 | 0.92; 12.55 | ++ | |
| Body weight gain | 8.74 | 1.12; 68.32 | ++ | |
| Thirst | 18.95 | 1.19; 301.39 | ++ | |
| Constipation | 1.60 | 1.19; 2.15 | ++ | |
| Edema | 1.8 | 0.18; 18.21 | + | |
| Drowsiness | 1.60 | 0.52; 4.91 | + | |
| Irritability | 8.19 | 0.45; 147.47 | + | |
| Palpitations | 1.55 | 0.29; 8.24 | + | |
| Blurred vision | 6.37 | 0.34; 119.6 | + | |
| Diarrhea | 1.21 | 0.29; 5.09 | + | |
| Gastritis | 0.9 | 0.31; 2.61 | +− | |
| Sweating | 1.14 | 0.33; 3.94 | +− | |
| Dizziness | 1.12 | 0.47; 2.66 | +− | |
| Nausea | 0.54 | 0.21; 1.38 | − | |
| Vomiting | 0.09 | 0; 1.59 | − | |
| Abdominal pain | 0.14 | 0.01; 2.68 | − | |
| Urinating difficulty | 0.40 | 0.04; 4.09 | − | |
| Insomnia | 0.12 | 0.02; 0.94 | −− | |
| Itching | 0.42 | 0.16; 1.07 | −− | |
| Nortriptyline | Drowsiness | 3.94 | 2.14; 7.28 | ++ |
| Constipation | 1.84 | 0.90; 3.74 | ++ | |
| Insomnia | 1.40 | 0.92; 2.13 | ++ | |
| Dizziness | 2.90 | 0.32; 26.10 | + | |
| Dry mouth | 2.04 | 0.75; 5.59 | + | |
| Heart burn | 3 | 0.14; 62.49 | + | |
| Increase in appetite | 2.78 | 0.11; 67.49 | + | |
| Nervousness | 2.78 | 0.11; 0.67 | + | |
| Orthostatic hypotension | 1.26 | 0.78; 2.03 | + | |
| Palpitations | 1.55 | 0.28; 8.61 | + | |
| Sedation | 1.26 | 0.78; 2.03 | + | |
| Sweating | 1.40 | 0.62; 3.15 | + | |
| Weight gain | 2.90 | 0.32; 26.10 | + | |
| Abdominal pain | 2.78 | 0.11; 67.49 | + | |
| Somnolence | 1 | 0.08; 13.02 | +− | |
| Headache | 1 | 0.08; 13.02 | +− | |
| Blurred vision | 0.33 | 0.02; 6.94 | − | |
| Desipramine | Dry mouth | 5.12 | 1.41; 18.57 | ++ |
| Constipation | 5.78 | 0.74; 44.97 | + | |
| Dizziness | 3 | 0.13; 66.8 | + | |
| Drowsiness | 11 | 0.68; 178.53 | + | |
| Headache | 5 | 0.27; 93.96 | + | |
| Insomnia | 5 | 0.27; 93.96 | + | |
| Loss of libido | 2.21 | 0.09; 51.85 | + | |
| Nausea | 5 | 0.27; 93.96 | + | |
| Shaking | 5 | 0.27; 93.96 | + | |
| Sweating | 7 | 0.4; 121.94 | + | |
| Vomiting | 3 | 0.13; 66.8 | + | |
| Milnacipran | ||||
| 2.26; 9.04 | Constipation | 4.52 | 3.29; 6.20 | +++ |
| 1.37; 5.57 | Vomiting | 2.77 | 1.80; 4.26 | +++ |
| 1.04; 3.62 | Dizziness | 1.94 | 1.46; 2.58 | +++ |
| 1.47; 2.25 | Nausea | 1.82 | 1.60; 2.08 | +++ |
| 1.04; 2.50 | Headache | 1.62 | 1.23; 2.12 | +++ |
| 1.09; 10.98 | Palpitations | 3.46 | 2.16; 5.53 | +++ |
| Dry mouth | 2.40 | 1.27; 4.53 | ++ | |
| Hot flush | 6.17 | 3.42; 11.13 | ++ | |
| Hypertension | 3.31 | 1.74; 6.28 | ++ | |
| Insomnia | 1.49 | 0.98; 2.27 | ++ | |
| Sweating | 4.97 | 2.58; 9.57 | ++ | |
| Tachycardia | 5.56 | 1.94; 15.94 | ++ | |
| Arthralgia | 1.5 | 0.16; 14.06 | + | |
| Fall | 4.52 | 0.25; 82.36 | + | |
| Fatigue | 2 | 0.23; 17.43 | + | |
| Respiratory infections | 1.07 | 0.71; 1.62 | +− | |
| Edema | 0.33 | 0.06; 1.93 | − | |
| Nasopharyngitis | 0.73 | 0.48; 1.12 | − | |
| Diarrhea | 0.68 | 0.42; 1.11 | −− | |
| Venlafaxine | Vomiting | 16.07 | 3.18; 81.29 | ++ |
| Somnolence | 7.39 | 0.97; 56.50 | ++ | |
| Drowsiness | 2.51 | 0.86; 7.28 | ++ | |
| Constipation | 1.76 | 0.51; 6.03 | + | |
| Jaw spasm | 4.39 | 0.52; 36.98 | + | |
| Loss of libido | 4.39 | 0.52; 36.98 | + | |
| Mydriasis | 3.64 | 0.42; 31.56 | + | |
| Nausea | 3.13 | 0.74; 13.85 | + | |
| Nightmares | 1.22 | 0.68; 2.21 | + | |
| Sedation | 6.35 | 0.35; 115.28 | + | |
| Sweating | 1.98 | 0.18; 21.37 | + | |
| Urinating difficulty | 1.5 | 0.67; 3.34 | + | |
| Headache | 1.06 | 0.95; 1.18 | 0 | |
| Fatigue | 1.06 | 0.95; 1.18 | 0 | |
| Dizziness | 0.93 | 0.25; 3.45 | +− | |
| Dry mouth | 1.04 | 0.66; 1.64 | +− | |
| Palpitations | 1.08 | 0.74; 1.57 | +− | |
| Loss of appetite | 1.08 | 0.79; 1.47 | +− | |
| Duloxetine | Constipation | 4.02 | 1.57; 10.33 | ++ |
| Dry mouth | 2.95 | 1.17; 7.43 | ++ | |
| Hyperhidrosis | 13.33 | 1.76; 101.14 | ++ | |
| Nausea | 4.11 | 1.15; 14.70 | ++ | |
| Dizziness | 2.72 | 0.77; 9.57 | + | |
| Dyspnoe | 3.03 | 0.12; 73.52 | + | |
| Hypertensive encephalopathy | 3.16 | 0.13; 76.69 | + | |
| Muscular weakness | 3.03 | 0.12; 73.52 | + | |
| Myocardial infarction | 1.52 | 0.24; 9.61 | + | |
| Osteoarthritis | 3.16 | 0.13; 76.69 | + | |
| Pruritus | 3.13 | 0.13; 73 | + | |
| Somolence | 2.47 | 0.24; 25.39 | + | |
| TIA | 3.22 | 0.34; 30.70 | + | |
| Wrist fracture | 3.16 | 0.13; 76.69 | + | |
| Diarrhea | 1.19 | 0.42; 3.37 | +− | |
| Headache | 0.73 | 0.20; 2.59 | − | |
| Vertigo | 0.70 | 0.14; 3.47 | − | |
| Chest pain | 0.70 | 0.12; 4.02 | − | |
| Mirtazapine | Dizziness | 3.61 | 0.96; 13.56 | ++ |
| Drowsiness | 1.56 | 0.84; 2.88 | ++ | |
| Sedation | 3.5 | 0.95; 12.9 | ++ | |
| Concentration disturbances | 2 | 0.19; 20.61 | + | |
| Dry mouth | 1.85 | 0.43; 7.94 | + | |
| Edema | 1.5 | 0.27; 8.19 | + | |
| Global weakness | 3 | 0.14; 65.55 | + | |
| Metallic taste | 3 | 0.14; 65.55 | + | |
| Swallowing difficulty | 3 | 0.14; 65.55 | + | |
| Weight gain | 6 | 0.78; 46.14 | + | |
| Nausea | 1 | 0.15; 6.53 | +− | |
| Sleep disturbances | 0.67 | 0.12; 3.64 | − | |
| Irritability | 0.2 | 0.03;1.59 | − | |
| Increased appetite | 0.6 | 0.16; 2.23 | − | |
| Fainting | 0.33 | 0.02; 7.28 | − | |
| Fluoxetine | Breathlessness | 2.58 | 0.11; 59.62 | |
| Dizziness | 1.71 | 0.17; 17.38 | + | |
| Edema | 1.71 | 0.17; 17.38 | + | |
| Headache | 1.29 | 0.24; 6.86 | ||
| Loss of appetite | 2.58 | 0.11; 59.62 | ||
| Loss of libido | 10.71 | 0.64; 178.16 | ||
| Nausea | 1.42 | 0.4; 5.17 | ||
| Palpitations | 2.58 | 0.11; 59.62 | ||
| Gastritis | 1.2 | 0.46; 3.13 | +− | |
| Dry mouth | 0.35 | 0.03; 3.67 | − |
Evidence is estimated according to risk ratios and corresponding 95%-CI obtained from meta-analyses.
+++/++, strong evidence for side effect under treatment; +, weak evidence for side effect under treatment; +−, inconclusive evidence; −, weak evidence for placebo-induced side effect; −−, strong evidence for placebo-induced side effect; RR, risk ratio; 95%-CI, 95%-confidence interval; PI, prediction interval.
Symptoms in “bold” show statistical significance + strong evidence, underlined symptoms are more often under placebo than under therapy, and evidence remains unclear for symptoms in “italic.”