However, he added, irritability is an indicator of depression in some patients. If symptoms persist for longer than 2 weeks, he added, a clinically meaningful affective disorder may have developed. Available Hyman and Katon agree that most depressed patients can be treated with antidepressants. For one thing, these drugs are easier to use in people with serious medical illnesses than are the older tricyclic antidepressants. The SSRIs cause fewer side effects, and patients don't have to take them as often.
Side effects can also occur with SSRIs, however.
The SSRIs can interfere with the metabolism of certain hepatically metabolized drugs that may be prescribed for the patient's underlying medical illness, Hyman warned. For a patient receiving a complex regimen of antiseizure drugs, SSRIs should probably be avoided. If they are used, careful monitoring of drug levels is required. Drugs, such as erythromycin, can also interact negatively with SSRIs. Alternatives to SSRIs, such as bupropion, are available, Hyman noted.