Adverse effects associated with selective serotonin reuptake inhibitors and tricyclic antidepressants: a meta-analysis

Table 2: Pooled differences between SSRIs and TCAs in percentages of patients reporting adverse effects
	SSRI; pooled difference relative to TCAs, %
Adverse effect	Fluoxetine	Fluvoxamine	Paroxetine	Sertraline	All SSRIs
Adverse effects for which there was no statistically significant difference between any 1 of the 4 SSRIs and all TCAs
Headache	+2	+2	–2	+4	+2
Tremor	–2	+1	–2	+5	–1
Urinary disturbance	–2	–2	+1	–2	–1
Hypotension	–9	–17	+12	+2	–5
Adverse effects that occurred statistically significantly more often with TCAs than with at least one of the SSRIs
Dry mouth	–32*	–22*	–21*	–30*	–29*
Constipation	–14*	–6	–4*	–10*	–11*
Dizziness	–13*	–6*	–8*	–7	–9*
Sweating	–3	–8*	–5	+1	–3*
Blurred vision	–5*	+1	–2	–4	–3*
Palpitations	–1	+3	–4*	–1	–2
Adverse effects that occurred statistically significantly more often with at least one of the SSRIs than with TCAs
Nausea	+10*	+12*	+2*	+18*	+10*
Anorexia	+4*	+2	+2	+5*	+5*
Diarrhea	+5	+13*	+6	+8	+8*
Insomnia	+8*	0	0	+5	+4*
Nervousness	+3	+7*	–4	+2	+4*
Fatigue	–4	–10	+2*	–6	–2
Adverse effects for which there was a statistically significant difference (occurring more often with SSRIs than with the group of TCAs) only for pooled rates
Agitation	+13	+7	+4	0	+6*
Anxiety	+4	+7	–1	–	+5*
Note: The entries in each of the columns headed by a specific drug name are from meta-analyses of trials of each of these SSRIs against any TCA. The entries in the final column are from meta-analyses of all of the trials of SSRIs against any TCA. *Adverse event occurred statistically significantly more frequently with SSRI (positive value) or TCA (negative value). Based on pooled rate difference obtained by meta-analysis of randomized controlled trials.

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