What are common pharmacologic side effects to monitor for antidepressants?

• A. Antidepressants cause liver toxicity in all patients.
• B. Hyponatremia is not a concern in older adults.
• C. Sleep disturbances are not a side effect to monitor.
• D. Antidepressants commonly cause GI issues, sleep disturbances, sexual dysfunction, weight changes, hyponatremia risk, and potential increased suicidality in some ages; monitor for serotonin syndrome with polypharmacy.

Answer: (C)

Antidepressants commonly affect several body systems because they alter serotonin and other neurotransmitters, leading to a range of adverse effects you must monitor. The most important and typical ones include gastrointestinal upset (nausea or diarrhea), sleep disturbances (insomnia or daytime sleepiness), sexual dysfunction, and weight changes. Hyponatremia is a specific risk to watch for in older adults, so sodium balance should be monitored in that population. There is also a concern about increased suicidality in certain age groups, particularly early in treatment, so ongoing safety assessment is essential. When multiple serotonergic medications are used together, serotonin syndrome becomes a potential danger that warrants vigilance for symptoms like agitation, confusion, rapid heart rate, and neuromuscular changes.

The other statements miss key points: liver toxicity is not universal to all antidepressants, and hyponatremia is indeed a concern in older adults. Sleep disturbances are a well-established side effect of many antidepressants, so they should be monitored rather than dismissed.