Adverse Drug Reaction Profiling of Antidepressant Drugs in Patients with Depressive Disorders in a Tertiary Level Hospital of Kathmandu: An Observational Study

Introduction: Psychiatric disorders have become a major disease burden, with conditions like depression contributing significantly to both disability and premature death. Though very commonly used, antidepressants can lead to different adverse drug reactions. This study aimed to profile suspected adverse drug reactions from antidepressants in Nepal, where monitoring and evaluation of such reactions remains limited like in other lower and middle-income countries. Methods: This was a prospective longitudinal observational study which enrolled 36 patients who visited the psychiatry outpatient department (OPD) or were admitted to psychiatry ward and received antidepressant drugs for depressive illness diagnosed according to ICD criteria 10 over a two-month period. A structured proforma was developed to systematically collect patient data and monitor adverse drug reactions as well as to record biochemical and metabolic parameters at baseline (day 0) and followed up at 6 months. Data was entered into Microsoft Office Excel 2016 and presented using descriptive statistics. Results: Fluoxetine and sertraline were each prescribed to 7 (19.44%) patients, making them the frequently prescribed antidepressants in this study. Among 36 patients, 86 adverse effects were reported. Nausea 15 (17.05%), dry mouth 10 (11.36%) and drowsiness 9 (10.46%) were commonly reported adverse effects. Selective serotonin reuptake inhibitors exhibit more adverse effects 41 (66.26%) than tricyclic antidepressants 6 (7.22%), norepinephrine dopamine reuptake inhibitors 7 (8.14%) and serotonin norepinephrine reuptake inhibitors 18 (20.93%). Conclusion: This study demonstrated that antidepressants are generally well-tolerated.