From the Guidelines
Side effects of SSRIs in children and adolescents can include dry mouth, nausea, diarrhea, heartburn, headache, somnolence, insomnia, dizziness, vivid dreams, changes in appetite, weight loss or gain, fatigue, nervousness, tremor, bruxism, and diaphoresis, with potentially serious adverse effects such as suicidal thinking and behavior, behavioral activation/agitation, hypomania, mania, sexual dysfunction, seizures, abnormal bleeding, and serotonin syndrome 1.
Common Side Effects
- Dry mouth
- Nausea
- Diarrhea
- Heartburn
- Headache
- Somnolence
- Insomnia
- Dizziness
- Vivid dreams
- Changes in appetite
- Weight loss or gain
- Fatigue
- Nervousness
- Tremor
- Bruxism
- Diaphoresis
Serious Side Effects
- Suicidal thinking and behavior
- Behavioral activation/agitation
- Hypomania
- Mania
- Sexual dysfunction
- Seizures
- Abnormal bleeding
- Serotonin syndrome
Management of Side Effects
To manage side effects, it is essential to take SSRIs as prescribed, with or without food as directed, and to report concerning symptoms promptly to the healthcare provider 1. Close monitoring for suicidality is recommended, especially in the first months of treatment and following dosage adjustments 1. Slow up-titration and close monitoring, particularly in younger children, can help minimize the risk of behavioral activation/agitation 1. Educating parents/guardians and patients about potential side effects is crucial to ensure prompt recognition and reporting of adverse effects 1.
From the FDA Drug Label
NSAIDs can cause serious side effects, including: Increased risk of a heart attack or stroke that can lead to death Increased risk of bleeding, ulcers, and tears (perforation) of the esophagus (tube leading from the mouth to the stomach), stomach and intestines The risk of getting an ulcer or bleeding increases with: past history of stomach ulcers, or stomach or intestinal bleeding with use of NSAIDs taking medicines called “corticosteroids”, “anticoagulants”, “SSRIs”, or “SNRIs” increasing doses of NSAIDs longer use of NSAIDs smoking drinking alcohol older age poor health advanced liver disease bleeding problems NSAIDs should only be used: exactly as prescribed at the lowest dose possible for your treatment for the shortest time needed Other side effects of NSAIDs include: stomach pain, constipation, diarrhea, gas, heartburn, nausea, vomiting and dizziness
The possible side effects of ibuprofen include:
- Cardiovascular events: increased risk of heart attack or stroke
- Gastrointestinal events: bleeding, ulcers, and tears of the esophagus, stomach, and intestines
- Other side effects: stomach pain, constipation, diarrhea, gas, heartburn, nausea, vomiting, and dizziness
- Serious side effects: liver problems, kidney problems, low red blood cells, life-threatening skin reactions, and life-threatening allergic reactions 2, 2, 2
From the Research
Side Effects of Medications
- Most common adverse drug reactions (ADRs) are linked to pharmacology, and no medicine has a single physiological effect, causing unwanted side effects in addition to their intended action, even when administered at the recommended dose 3.
- The higher the number of medicines people take, the higher their risk of ADRs, which can be anticipated and avoided by understanding the way in which the body processes medicines and the factors that affect these mechanisms 3.
- Adverse drug reactions are an important cause of morbidity and mortality, and increase health costs, with pharmacovigilance systems allowing the identification and prevention of the risks associated with use of a drug 4.
Prevention and Management of Side Effects
- Systemic glucocorticoids can produce significant morbidity for patients due to their multiple side effects, and clinicians should counsel patients about these complications and guide them on prevention and management 5.
- Nurse-administered 'side-effect' checklists can be an effective strategy to focus professionals' attention on long-term problems and minimize side-effects, with the checklists highlighting several problems and increasing the mean number of problems actioned per client 6.
- Consumers may have difficulty correctly interpreting risk information provided about prescription drugs, with some consumers likely to interpret precautions as potential side effects, which might affect consumer preferences, treatment decisions, and medication safety 7.
Factors Affecting Side Effects
- The dose and duration of glucocorticoid therapy can prompt concern for individual side effects, and clinicians should be aware of these factors when counseling patients 5.
- Age, education, literacy, and other factors may not appear to predict precaution interpretation, but healthcare providers should still assess patients' understanding of precautions and potential side effects and address any misunderstandings 7.