Depression Medication: Patients Report 20 Times More Side Effects Than Recorded in Charts

A study from Rhode Island Hospital shows that patients report side effects from medication for the treatment of depression 20 times more than psychiatrists have recorded in the charts. The researchers recommend the use of a self-administered patient questionnaire in clinical practice to improve the recognition of side effects for patients in treatment. The study is published in the Journal of Clinical Psychiatry.

Researchers asked 300 patients in ongoing treatment for depression to complete a self-administered version of the Toronto Side Effects Scale (TSES). The patients rated the frequency of the 31 side effects and the degree of trouble they experienced. Those patients' charts were then examined to extract side effects information recorded by the treating psychiatrist. The findings indicate that the mean number of side effects reported by the patients on the TSES was 20 times higher than the number recorded by the psychiatrist. When the self-reported side effects were limited to "frequently occurring" or "very bothersome" the rate was still found to be two to three times higher than recorded in their charts. According to researchers, "Despite the importance that side effects have on premature medication discontinuation, there is some evidence that clinicians may not do a thorough job of eliciting information regarding their presence. This study finds that clinicians do not record in their progress notes most side effects reported on a side effects questionnaire."

Bonnie - if this is an indication of how other health professionals log side effects, we are looking at an even greater systemic issue than what already exists.