Nausea, ejaculation failure, insomnia, diarrhea, dry mouth, somnolence, dizziness, tremor, headache, excessive sweating, fatigue, and decreased libido are the common adverse effects associated with<unk>  with the greatest difference from placebo. Those that most often resulted in interruption of the treatment are nausea, diarrhea and insomnia. The incidence of diarrhea is higher with<unk>  – especially when prescribed at higher doses – in comparison with other SSRIs. Over more than six months of<unk>  therapy for depression, people showed a nonsignificant weight increase of 0.1%. Similarly, a 30-month-long treatment with<unk>  for OCD resulted in a mean weight gain of 1.5% (1 kg). Although the difference did not reach statistical significance, the average weight gain was lower for fluoxetine (1%) but higher for citalopram, fluvoxamine and paroxetine (2.5%). Of the<unk>  group, 4.5% gained a large amount of weight (defined as more than 7% gain). This result compares favorably with placebo, where, according to the literature, 3–6% of patients gained more than 7% of their initial weight. The large weight gain was observed only among female members of the<unk>  group; the significance of this finding is unclear because of the small size of the group. Over a two-week treatment of healthy volunteers,<unk>  slightly improved verbal fluency but did not affect word learning, short-term memory, vigilance, flicker fusion time, choice reaction time, memory span, or psychomotor coordination. In spite of lower subjective rating, that is, feeling that they performed worse, no clinically relevant differences were observed in the objective cognitive performance in a group of people treated for depression with<unk>  for 1.5 years as compared to healthy controls. In children and adolescents taking<unk>  for six weeks for anxiety disorders, 18 out of 20 measures of memory, attention and alertness stayed unchanged. Divided attention was improved and verbal memory under interference conditions decreased marginally. Because of the large number of measures taken, it is possible that these changes were still due to chance. The unique effect of<unk>  on dopaminergic neurotransmission may be related to these effects on cognition and vigilance.<unk>  has a low level of exposure of an infant through the breast milk and is recommended as the preferred option for the antidepressant therapy of breast-feeding mothers. There is 29–42% increase in congenital heart defects among children whose mothers were prescribed<unk>  during pregnancy, with<unk>  use in the first trimester associated with 2.7-fold increase in septal heart defects. Abrupt interruption of<unk>  treatment may result in withdrawal or discontinuation syndrome. Dizziness, insomnia, anxiety, agitation, and irritability are its common symptoms. It typically occurs within a few days from drug discontinuation and lasts a few weeks. The withdrawal symptoms for<unk>  are less severe and frequent than for paroxetine, and more frequent than for fluoxetine. In most cases symptoms are mild, short-lived, and resolve without treatment. More severe cases are often successfully treated by temporary reintroduction of the drug with a slower tapering off rate.<unk>  and SSRI antidepressants in general may be associated with bruxism and other movement disorders.<unk>  appears to be associated with microscopic colitis, a rare condition of unknown etiology. Sexual Like other SSRIs,<unk>  is associated with sexual side effects, including sexual arousal disorder, erectile dysfunction and difficulty achieving orgasm. While nefazodone and bupropion do not have negative effects on sexual functioning, 67% of men on<unk>  experienced ejaculation difficulties versus 18% before the treatment. Sexual arousal disorder, defined as "inadequate lubrication and swelling for women and erectile difficulties for men", occurred in 12% of people on<unk>  as compared with 1% of patients on placebo. The mood improvement resulting from the treatment with<unk>  sometimes counteracted these side effects, so that sexual desire and overall satisfaction with sex stayed the same as before the<unk>  treatment. However, under the action of placebo the desire and satisfaction slightly improved. Some people continue experiencing sexual side effects after they stop taking SSRIs. Suicide The FDA requires all antidepressants, including<unk> , to carry a boxed warning stating that antidepressants increase the risk of suicide in persons younger than 25 years. This warning is based on statistical analyses conducted by two independent groups of FDA experts that found a 100% increase of suicidal thoughts and behavior in children and adolescents, and a 50% increase – in the 18–24 age group. Suicidal ideation and behavior in clinical trials are rare. For the above analysis, the FDA combined the results of 295 trials of 11 antidepressants for psychiatric indications in order to obtain statistically significant results. Considered separately,<unk>  use in adults decreased the odds of suicidal behavior with a marginal statistical significance by 37% or 50% depending on the statistical technique used. The authors of the FDA analysis note that "given the large number of comparisons made in this review, chance is a very plausible explanation for this difference". The more complete data submitted later by the<unk>  manufacturer Pfizer indicated increased suicidal behavior. Similarly, the analysis conducted by the UK MHRA found a 50% increase of odds of suicide-related events, not reaching statistical significance, in the patients on<unk>  as compared to the ones on placebo.
Sertraline
Citalopram
Escitalopram
Clomipramine
Trimipramine
Mirtazapine
Asenapine
Quetiapine