The most common side effects are gastrointestinal, especially nausea. These are dose related, often mild, and usually settle with continual use.
Side effects include:
- psychiatric - anxiety, panic attacks, nervousness - although this does not effect the outcome in depressed patients with anxiety, hypomania or mania, hallucinations, depersonalisation
- neurological - tremor, seizures, movement disorders, serotonin syndrome
- cardiovascular - postural hypotension
- metabolic and endocrine - SIADH, hyponatraemia, hyperprolactinaemia
- hepatobiliary - abnormalities of liver function tests
- musculoskeletal - myalgia, arthralgia
- urological - urinary retention
- reproductive disorders - sexual dysfunction such as anorgasmia and ejaculation disorders, galactorrhoea
- skin disorders - pruritus, rash, ecchymoses, sweating, angioedema
- gastrointestinal - nausea, vomiting, diarrhoea, dry mouth, anorexia; increase in risk of gastrointestinal bleeding (see linked item)
- others including dizziness, insomnia, drowsiness, fatigue, anaphylactoid reactions, aplastic anaemia, haemolytic anaemia, pancreatitis, thrombocytopaenia
Reference:
- (1) Current Problems in Pharmacovigilance (2000), 26, 11-12.