From the Research
The ranking of gastrointestinal side effects of Selective Serotonin Reuptake Inhibitors (SSRIs) from most to least common is: nausea, diarrhea, constipation, vomiting, abdominal pain, and dyspepsia (indigestion), with sertraline having the highest probability of digestive side effects and fluoxetine having the lowest probability. According to the most recent and highest quality study 1, the probability of digestive side effects for each SSRI is as follows:
- Sertraline: 0.611
- Paroxetine: not specified
- Escitalopram: better than paroxetine and sertraline
- Citalopram: not specified
- Fluoxetine: 0.548 The study also found that escitalopram was better than paroxetine (odds ratio [OR] =0.62,95% confidence interval [CI] 0.43-0.87) and sertraline (OR=0.56,95% CI 0.32-0.99) in terms of gastrointestinal tolerability. Other studies, such as 2 and 3, also reported on the gastrointestinal side effects of SSRIs, but the most recent and highest quality study 1 provides the most reliable information on this topic. It is essential to note that individual responses to SSRIs can vary, and if side effects persist or are severe, discussing with a healthcare provider about switching to a different SSRI may be beneficial. Some key points to consider when managing gastrointestinal side effects of SSRIs include:
- Starting with a lower dose and gradually increasing it to minimize side effects
- Taking the medication with food to reduce nausea
- Staying well-hydrated and maintaining a fiber-rich diet to manage constipation
- Considering switching to a different SSRI if side effects persist or are severe.