SIDE EFFECTS:
Ask the Pharmacist: Archives
Q: What is the difference between Prozac and Zoloft in terms of how they workand side effects they cause? What is the likelihood of an increase in migraines or seizures among people taking either of these drugs?
Harold J. DeMonaco, M.S. is the Director of Drug Therapy Management and theChair of the Human Research Committee at the Massachusetts General Hospital. He is an author of over twenty publications in the pharmacy and medical literature and routinely reviews manuscript submissions for eight medical journals.
A:
Prozac and Zoloft are two members of a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). Other members of this class of drugs are Paxil, Luvox and Celexa.
All have the same basic mechanism of action but all have slight differences in the way they work, and, as a result, difference in the side effects they produce. All are equally effective in the treatment of depression.
Here is the information from the package inserts for each of the drugs.
The number represents the percentage of patients who experienced the
side effect during clinical trials.
Side Effect Prozac Luvox Paxil Zoloft Celexa
Nausea......................21.1 40 25.7 26 21
Headache..................20.3 22 17.6 20 Not reported
Nervousness.............14.9 12 5.2 3.4 Not reported
Sedation....................11.6 22 23.3 13 18
Insomnia....................13.8 21 13.3 16 15
Dry Mouth....................9.5 14 18.1 16 20
Diarrhea....................12.3 11 11.6 18 8
Weakness/Fatigue......4.2 14 15.0 11 5
Anxiety/Agitation.........9.4 5 5.0 5.6 4
Sexual Dysfunction......1.9 8 12.9 16 6
Loss of appetite.......... 8.7 6 6.4 2.8 4
The incidence of seizures with the SSRIs is so low that it is impossible to
distinguish among the members of the class. Overall, the incidence of seizures with all antidepressants is less than 1 percent.
I know of no increased risk of migraine associated with the use of any SSRI antidepressant. Migraine is frequently seen in patients with depression, however.
January 23, 2001
