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Potential Medical and Surgical Complications of Serotonergic Antidepressant Medications

Received January 4, 2006; revised July 14, 2006; accepted July 26, 2006. From the Dept. of Psychiatry, McGill University, Montreal, Canada and the Consultation–Liaison Service, Dept. of Psychiatry, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Canada. Send correspondence and reprint requests to Karl Looper, M.D., Sir Mortimer B. Davis Jewish General Hospital, Office A-540, 3755 Chemin de la Côte-Ste-Catherine, Montreal, Quebec, H3T 1E2, Canada. e-mail: karl.looper{at}mcgill.ca

Serotonergic antidepressants are the most widely used group of antidepressant medications. Although generally considered to have a favorable adverse-effect profile, serotonergic antidepressants are associated with potentially dangerous medical complications, some of which have only recently become apparent to patients and clinicians. This article reviews the association of serotonergic antidepressants and the following medical complications: syndrome of inappropriate antidiuretic hormone secretion, bleeding, serotonin syndrome, serotonin-discontinuation syndrome, and adverse pregnancy and neonatal effects. Physicians need to remain aware of these potential medical complications and integrate this information into their clinical decision-making, informed-consent process, baseline assessment, and follow-up monitoring.

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