Roose · The Journal of clinical psychiatry 1999 · narrative review · n=?

Tolerability and patient compliance.

Cited 36 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and mechanism-based pharmacological reasoning with no systematic search methodology or original clinical trial data reported.

PubMed 10446736 · record verified 2026-08-27

What was done

This narrative review describes how differences in receptor interactions among antidepressants (particularly newer agents like SSRIs and mirtazapine compared to tricyclic compounds) influence tolerability, adverse effect profiles, and patient compliance.

What was found

No numerical data, statistics, or sample sizes are reported in the abstract. Qualitatively, newer antidepressants demonstrate improved tolerability, cardiac safety, and safety in overdose compared to tricyclics. Mirtazapine's H1 blockade is linked to transient somnolence and weight gain, its 5-HT2 blockade to absent sexual dysfunction and agitation, and its 5-HT3 blockade to an absence of gastrointestinal side effects.

Why it matters

Recognizing specific receptor-mediated adverse effect profiles allows clinicians to match antidepressant selection to individual patient tolerability concerns, potentially improving treatment adherence.

Limits

The abstract provides no empirical quantitative data, effect estimates, or systematic review methodology. Conclusions reflect narrative pharmacological reasoning rather than direct clinical trial evidence.

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