Are selective serotonin reuptake inhibitors well tolerated in somatizing depressives?

This retrospective evaluation included 89 patients who participated in two independent clinical investigations of the antidepressant medications paroxetine and fluoxetine. Baseline gastrointestinal (GI) somatic symptoms, as indicated by the baseline scores on the Hamilton Rating Scale for Depression (HAM-D) items 11, 12, and 16, the Symptom Checklist (SCL) items 19 and 40, and the Covi Anxiety Scale somatic anxiety item were analyzed for their discriminative ability in predicting which patients would subsequently develop adverse GI side effects on medication. Subjects with baseline complaints of nausea or upset stomach (SCL #40), GI somatic symptoms (HAM-D #11 and #12, Covi somatic anxiety), or weight loss (HAM-D #16) were not statistically more likely to develop GI side effects on paroxetine or fluoxetine. Only a baseline complaint of appetite loss (SCL #19) was associated with subsequent GI side effects on paroxetine to a statistically significant degree (p < .05).