Abstract
Objective:
To present information on special considerations in the prescription of selective serotonin reuptake inhibitor (SSRI) antidepressant drugs to women.
Methods:
Literature review and analysis of adverse drug reactions to SSRIs reported to Health Canada between 1986 and 1996.
Results:
SSRIs are prescribed twice as often to women as to men. Special considerations are required of the social context in which the illness occurs, biological aspects of the illness, the effects of endogenous and exogenous sex steroids, menstruation, pregnancy, lactation, and menopause. Serious or fatal side effects are most commonly drug–drug or drug–alcohol interactions, and endocrine side effects are more common in women than men.
Conclusions:
Although SSRIs are relatively effective and safe when prescribed to women, further research is required for long-term follow-up of children exposed to these drugs in utero or during lactation. Continued study of the effects of sex steroids on pharmacodynamics and kinetics and ongoing monitoring and reporting of side effects in women is required. Special consideration of endocrine side effects and drug–drug and drug–alcohol interactions are needed for optimal safety.