ARE THERE SPECIAL CONSIDERATIONS IN THE PRESCRIPTION OF SEROTONIN REUPTAKE INHIBITORS FOR WOMEN

Objective: To present information on special considerations in the pre scription of selective serotonin reuptake inhibitor (SSRI) antidepress ant drugs to women. Methods: Literature review and analysis of adverse drug reactions to SSRIs reported to Health Canada between 1986 and 19 96. Results: SSRIs are prescribed twice as often to women as to men. S pecial considerations are required of the social context in which the illness occurs, biological aspects of the illness, the effects of endo genous and exogenous sex steroids, menstruation, pregnancy, lactation and menopause. Serious or fatal side effects ave most commonly drug-dr ug or drug-alcohol interactions, and endocrine side effects are more c ommon in women than men. Conclusions: Although SSRIs are relatively ef fective and safe when prescribed to women, further research is require d for long-term follow-up of children exposed to these drugs in utero or during lactation. Continued study of the effects of sex steroids on pharmacodynamics and kinetics and ongoing monitoring and reporting of side effects in women is required Special consideration of endocrine side effects and drug-drug and drug-alcohol interactions are needed fo r optimal safety.