The applicability of antidepressants in the depressed medically ill: an open clinical trial with fluoxetine.

In the literature the side-effects and medical complications of tricyclic antidepressants (TCAs), in the medically ill have been extensively reviewed. This study uses a prospective design to examine these issues' questions in an almost solely in-patient C-L population (N = 37) treated with a serotinergic antidepressant (fluoxetine). A first remarkable finding is the fact that 83% of the patients have complaints comparable with the side-effects of the drug, prior to its administration. Second, although the drop-out rates (DO) are comparable with those in earlier studies, in this study DO do not seem to be related to the seriousness of the side-effects of the drug. The more serious side-effects were hyponatremia (N = 1) and gastrointestinal symptoms (N = 3). In contrast to TCAs no psychiatric side-effects have to be reported. Therefore this study suggests that with good medical supervision fluoxetine can be used in the treatment of seriously medically ill patients with depressive co-morbidity.