Incidence Of Major Side Effects Research Articles

Examining Side Effects of the Sputnik V COVID-19 Vaccine

Background: As a result of the COVID-19 pandemic, many vaccines were developed to counter the disease, including the vector-based Sputnik V vaccine. This study aims to identify the side effects of the Sputnik V COVID–19 vaccine in a medical center and compare the results with the previous reports. Methods: A questionnaire-based study was performed after the injection of the first and second doses of the vaccine to assess the side effects experienced by the participants. It was performed by reviewing similar previous studies. Results: Injection site pain, muscle pain, fever, fatigue, chills, and headache were the most common side effects of the vaccine. The incidence of major side effects decreased with age and was lower in men. In our study and others, the incidence of side effects was decreased in the second dose. In some studies, participants with a previous history of Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCOV-2) infection developed more side effects, especially injection site pain, muscle pain, and fatigue. Conclusion: Most studies agree with our reported results. Serious side effects of this vaccine are rare and may be considered tolerable in adults.

Comparison the Efficacy of Ketamine on the Patients Undergoing Elective Surgery for Prevention of Postoperative Shivering

Introduction: Patients frequently suffer from shivering following surgery. The shivering experienced by the patients may be a natural, thermal regulatory response to central hypothermia or as a result of the release of cytokines during the surgical process. This is unpleasant and occurs following surgery in 30-65% of patients who have received general anesthetics. Shivering increases the muscular activity, O2 consumption, CO2 production and may result in hypoxaemia, hypercarbia and lactic acidosis. It is not only uncomfortable but also cold sensation which is even worse feeling than pain sensation. Objective: To assess the Comparison the efficacy of ketamine on the patients undergoing elective surgery for prevention of postoperative shivering. Material & Methods: In this prospective study was conduct at the dept. of Anaesthesia, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh from January to June-2021. Fifty (50) patients included in our study. The inclusion criteria were women aged between 30-65 years and ASA-PS classes I and II. Patients preoperative period were fasted at least 6 hrs and on arrival at OT I/V line was inserted; pulse, BP respiratory rate and SpO2 were recorded. Results: In our study fifty two (52) patients demographic data concerning the patient age, weight as well as duration of anaesthesia and type of surgery were comparable in two groups which are fairly matched. In preoperative situation in Group A mean pulse rate was 79 ±2.4, in Group B 82 ±1.5, mean anterial pressure 92.71±1.05 (Group A), 94.01±1.14 (Group B), SpO2 99±0.56 Group A, 98 ±0.26 (Group B) which showed no significant difference between the groups. In the postoperative period, incidences of shivering were 80.07% & 50% in Group-A and Group-B which are highly significant between the groups P<.001 Cardiovascular parameters SAP, DAP, MAP and SpO2 between the groups were not significant P>.05. The study showed that patients of Group-B were less shivering with good recovery. Conclusion: In concluded that the post-operative shivering are the most common complaints. The aetiology of postoperative shivering is multifactorial including anesthetic, patients and surgical factors. Antishivering prophylaxis may be justified in patients who are at great risk of developing post-operative shivering after general anaesthesia. The incidence of major side effects is not significant in ketamine group and contributes to some extent to post-operative analgesia.

Factors Associated With US Adults’ Likelihood of Accepting COVID-19 Vaccination

The development of a coronavirus disease 2019 (COVID-19) vaccine has progressed at unprecedented speed. Widespread public uptake of the vaccine is crucial to stem the pandemic. To examine the factors associated with survey participants' self-reported likelihood of selecting and receiving a hypothetical COVID-19 vaccine. A survey study of a nonprobability convenience sample of 2000 recruited participants including a choice-based conjoint analysis was conducted to estimate respondents' probability of choosing a vaccine and willingness to receive vaccination. Participants were asked to evaluate their willingness to receive each hypothetical vaccine individually. The survey presented respondents with 5 choice tasks. In each, participants evaluated 2 hypothetical COVID-19 vaccines and were asked whether they would choose vaccine A, vaccine B, or neither vaccine. Vaccine attributes included efficacy, protection duration, major adverse effects, minor adverse effects, US Food and Drug Administration (FDA) approval process, national origin of vaccine, and endorsement. Levels of each attribute for each vaccine were randomly assigned, and attribute order was randomized across participants. Survey data were collected on July 9, 2020. Average marginal component effect sizes and marginal means were calculated to estimate the relationship between each vaccine attribute level and the probability of the respondent choosing a vaccine and self-reported willingness to receive vaccination. A total of 1971 US adults responded to the survey (median age, 43 [interquartile range, 30-58] years); 999 (51%) were women, 1432 (73%) White, 277 (14%) were Black, and 190 (10%) were Latinx. An increase in efficacy from 50% to 70% was associated with a higher probability of choosing a vaccine (coefficient, 0.07; 95% CI, 0.06-0.09), and an increase from 50% to 90% was associated with a higher probability of choosing a vaccine (coefficient, 0.16; 95% CI, 0.15-0.18). An increase in protection duration from 1 to 5 years was associated with a higher probability of choosing a vaccine (coefficient, 0.05 95% CI, 0.04-0.07). A decrease in the incidence of major adverse effects from 1 in 10 000 to 1 in 1 000 000 was associated with a higher probability of choosing a vaccine (coefficient, 0.07; 95% CI, 0.05-0.08). An FDA emergency use authorization was associated with a lower probability of choosing a vaccine (coefficient, -0.03; 95% CI, -0.04 to -0.01) compared with full FDA approval. A vaccine that originated from a non-US country was associated with a lower probability of choosing a vaccine (China: -0.13 [95% CI, -0.15 to -0.11]; UK: -0.04 [95% CI, -0.06 to -0.02]). Endorsements from the US Centers for Disease Control and Prevention (coefficient, 0.09; 95% CI, 0.07-0.11) and the World Health Organization (coefficient, 0.06; 95% CI, 0.04-0.08), compared with an endorsement from President Trump were associated with higher probabilities of choosing a vaccine. Analyses of participants' willingness to receive each vaccine when assessed individually yielded similar results. An increase in efficacy from 50% to 90% was associated with a 10% higher marginal mean willingness to receive a vaccine (from 0.51 to 0.61). A reduction in the incidence of major side effects was associated with a 4% higher marginal mean willingness to receive a vaccine (from 0.54 to 0.58). A vaccine originating in China was associated with a 10% lower willingness to receive a vaccine vs one developed in the US (from 0.60 to 0.50) Endorsements from the Centers for Disease Control and Prevention and World Health Organization were associated with increases in willingness to receive a vaccine (7% and 6%, respectively) from a baseline endorsement by President Trump (from 0.52 to 0.59 and from 0.52 to 0.58, respectively). In this survey study of US adults, vaccine-related attributes and political characteristics were associated with self-reported preferences for choosing a hypothetical COVID-19 vaccine and self-reported willingness to receive vaccination. These results may help inform public health campaigns to address vaccine hesitancy when a COVID-19 vaccine becomes available.

INFLIXIMAB THERAPY IN PATIENTS WITH NONINFECTIOUS INTERMEDIATE UVEITIS RESISTANT TO CONVENTIONAL IMMUNOMODULATORY THERAPY.

To examine the efficacy and safety of infliximab therapy in the treatment for noninfectious intermediate uveitis resistant to conventional immunomodulatory therapy. Forty-four eyes of 23 patients with resistant noninfectious intermediate uveitis who were treated with infliximab infusions for a minimum period of 3 months were included. Demographic data, clinical data, and fluorescein angiography and optical coherence tomography findings were collected from the Massachusetts Eye Research and Surgery Institution database between August 2005 and February 2014. Clinical response, improvement in ancillary test findings, and major side effects were evaluated. Nineteen patients (82.6%) achieved remission. The mean duration of treatment to induce remission was 3.99 ± 3.06 months (range, 2-14.7). Cystoid macular edema was the only complication observed during the course of the treatment in 1 eye (2.27%). One patient (4.3%) developed major side effects. None of the patients developed central or peripheral demyelinating neuropathies or multiple sclerosis. At 6 months after remission, logarithm of the minimum angle of resolution visual acuity (P = 0.006) and central macular thickness (P = 0.03) showed significant improvement in patients who achieved remission. A significant number of patients achieved remission on infliximab therapy. The incidence of major side effects in our cohort was low.

Adverse Effects of Bevacizumab During Treatment for Metastatic Colorectal Cancer

Objective:Bevacizumab has been increasingly used in combination chemotherapy for the treatment of metastatic or recurrent colorectal cancer.The aim of this report is to underline the possible risks associated with bevacizumab use. Methods:Between July 2005 and March 2013, a total of 130 patients with metastatic colorectal cancer who received oxaliplatin as first-line chemotherapy were divided into 2 groups those treated with bevacizumab (group A) and those without (group B), and compared. The primary endpoint was to clarify the profile of bevacizumab - induced adverse effects. Secondary endpoints examined therapeutic effects, including overall survival (OS). Results:The incidence of major side effects was almost equivalent, except for bleeding, between the 2 groups. With regard to the therapeutic effects, 1 patient in group A showed complete disappearance of multiple lung metastases without any evidence of recurrence. The median OS was 926 days (95% confidence interval [CI], 756 - 1257) in group A and 534 days (95% CI, 421 - 621) in group B (p < 0.01). Conclusion:The results demonstrate that bevacizumab prolonged survival in these patients although there was an increased risk of clinically significant bleeding.

Outcomes of transperineal template‐guided prostate biopsy in 409 patients

To present the template-guided transperineal prostate biopsy (TPB) outcomes for patients of two urologists from a single institution. We conducted a prospective study of 409 consecutive men who underwent TPB between December 2006 and June 2008 in a tertiary referral centre using a standardized 14-region technique. The procedure was performed as day surgery under general anaesthesia with fluoroquinolone antibiotic cover. Follow-up took place within 2 weeks, during which time men were interviewed using a standardized template. Results were compared with those of the Australian national prostate biopsy audits performed by the Urological Society of Australia and New Zealand (USANZ). Indications for biopsy included elevated prostate-specific antigen (PSA) level (75%), with a median PSA level of 6.5 ng/mL, abnormal digital rectal examination (8%) and active surveillance (AS) re-staging (18%). The mean patient age was 63 years and two-thirds of patients were undergoing their first biopsy. A positive biopsy was found in 232 men, 74% of whom had a Gleason score of ≥7. The overall cancer detection rate was 56.7% (USANZ 2005 national audit = 56.5%). Stratified between those having their first TPB or a repeat procedure (after a previous negative biopsy), the detection rates were 64.4 and 35.6%, respectively. Significantly higher detection rates were found in prostates <50 mL in volume than in larger prostates (65.2 vs 38.3%, respectively, P < 0.001). Haematuria was the most common side effect (51.7%). Others included dysuria (16.4%), acute urinary retention (4.2%) and fever (3.2%). One patient (0.2%) had septicaemia requiring i.v. antibiotics. Repeat biopsy was not associated with increased complication rates. TPB is a safe and efficacious technique, with a cancer detection rate of 56.7% in the present series, and a low incidence of major side effects. Stratified by prostate volume, the detection rate of TPB was higher in smaller glands. Given the relatively low rate of serious complications, clinicians could consider increasing the number of TPB biopsy cores in larger prostates as a strategy to improve cancer detection within this group. Conversely, in patients on AS programmes, a staging TPB may be a superior approach for patients undergoing repeat biopsy so as to minimize their risk of serious infection.

Propofol/alfentanil and propofol/ketamine procedural sedation in children with acute lymphoblastic leukaemia: safety, efficacy and their correlation with pain neuromediator expression

Invasive procedures, such as the lumbar puncture, can cause anxiety and pain in children undergoing treatment for acute lymphoblastic leukaemia (ALL). We investigated the safety and efficacy of two different protocols for analgo-sedation in 20 children with ALL undergoing lumbar puncture. We have conducted a prospective, cross-over study. Protocol A was composed of an association between propofol and alfentanil. Protocol B consisted in the combination of propofol and ketamine. We also evaluated the levels of nerve growth factor, substance P and enkephalins in the cerebrospinal fluid of these patients. All patients showed a satisfactory sedation and analgesia. We found a statistically significant difference of vital parameters between protocol A and protocol B, while there were no significant differences between sedation scores and the other parameters evaluated. Patients in protocol A showed a higher incidence of major side effects, such as respiratory depression. Pain neuromediator levels did not show any statistical difference between the two groups. This study shows that both protocols are effective to obtain a good sedation and analgesia in children with ALL undergoing lumbar puncture, but the association between propofol and ketamine appears to be safer due to the lower incidence of side effects.

Safety and efficacy of two protocols for sedation in pediatric oncology procedures

Abstract Invasive procedures, such as the lumbar puncture, can cause anxiety and pain in children undergoing treatment for acute lymphoblastic leukemia (ALL). We investigated the safety and efficacy of two different protocols for pain relief in 20 children with ALL undergoing lumbar puncture. Protocol A was composed of an association between propofol and alfentanil. Protocol B consisted in the combination of propofol and ketamine. Vital and behavioural parameters, sedation and pain scores were recorded at different times during and after the procedure. All patients showed a satisfactory sedation and analgesia. We found a statistically significant difference of vital parameters between protocol A and protocol B, while there were no significative differences between sedation scores and the other parameters evaluated. Patients in protocol A showed a higher incidence of major side effects, such as respiratory depression. Our results show that both protocols are effective to obtain a good sedation and analgesia in children with ALL undergoing lumbar puncture, but the association between propofol and ketamine appears more safe due to the lower incidence of side effects.

Benefits of achieving the NCEP optional LDL-C goal among elderly patients with ACS

To assess the efficacy and safety of the achievement of the NCEP goal of LDL-C <1.8 mmol/L in elderly patients with ACS. The relationship between LDL-C at 30 days after ACS and subsequent clinical outcomes were compared among elderly patients (aged > or =70 years) vs. younger counterparts in the PROVE IT-TIMI 22 trial, using the composite endpoint of death, myocardial infarction, or unstable angina. Among 634 elderly patients, the achievement of the NCEP goal was associated with an 8% absolute and a 40% relative lower risk of events [Hazard ratio (HR) 0.60, 95% confidence interval (CI) 0.41-0.87, P = 0.008] vs. corresponding benefits of 2.3 and 26% in 3150 younger patients (HR 0.74, 95% CI 0.59-0.94, P = 0.013). The estimated number of events preventable among the elderly by the achievement of these goals was 80 events at 2 years for every 1000 patients at goal vs. those not at goal, compared with 23 events potentially prevented in younger patients. The incidence of major side effects among the elderly was similar to that in younger patients and did not differ with the intensity of the statin regimen. Among elderly ACS patients, achieving the new NCEP LDL-C optional goal as part of a secondary prevention strategy can be both as safe and effective as in younger patients.

Tolerance and safety of superficial chemical peeling with salicylic acid in various facial dermatoses

Chemical peeling is a skin-wounding procedure that may have some potentially undesirable side-effects. The present study is directed towards safety concerns associated with superficial chemical peeling with salicylic acid in various facial dermatoses. The study was a non-comparative and a prospective one. Two hundred and sixty-eight patients of either sex, aged between 10 to 60 years, undergoing superficial chemical peeling for various facial dermatoses (melasma, acne vulgaris, freckles, post-inflammatory scars/pigmentation, actinic keratoses, plane facial warts, etc.) were included in the study. Eight weekly peeling sessions were carried out in each patient. Tolerance to the procedure and any undesirable effects noted during these sessions were recorded. Almost all the patients tolerated the procedure well. Mild discomfort, burning, irritation and erythema were quite common but the incidence of major side-effects was very low and these too, were easily manageable. There was no significant difference in the incidence of side-effects between facial dermatoses (melasma, acne and other pigmentary disorders). Chemical peeling with salicylic acid is a well tolerated and safe treatment modality in many superficial facial dermatoses.

Adjuvant postoperative radiotherapy in rectal cancer: 148 cases treated at Florence University with 8 years median follow-up

Background and purpose. To analyse the outcome, the treatment related side effects, the prognostic significance of clinical parameters in a group of patients with rectal cancer receiving postoperative radiotherapy after radical resection. Materials and methods. From 1980 to 1990 148 consecutive patients with rectal carcinoma stage B2–B3 or C1–C2–C3 were treated with postoperative radiotherapy after radical surgery. All patients received 50 Gy in 25 sessions in 5 weeks. In 42 a ‘flash’ dose of 5 Gy was also given within 24 h before surgery. Median follow up was 8.1 years. Results. At 5 years the overall survival was 54%, the determined (cancer specific) survival 61%, the local recurrence-free survival 88%. The influence of stage, histotype, distance from anal margin, type of surgery, number of involved nodes and flash dose were analysed. Overall and determined survival and distant metastasis rate were significantly influenced ( P < 0.005) by the pathological stage. Patients with more than 3 involved nodes presented a significantly lower determined survival ( P < 0.001) and a higher distant relapse rate ( P < 0.005) than those with 3 or less involved nodes. A higher determined survival ( P < 0.01) was also found in patients receiving the preoperative ‘flash’; this group was however unbalanced in respect to the relative number of cases with 3 or less involved nodes. The incidence of major side effects requiring surgery or hospitalization for medical treatment was 35% before 1985 and 12% thereafter. The systematic use of small bowel visualization during simulation and the discontinuation of the flash dose were the main modifications introduced in the second period. As a consequence of the small bowel visualization the size of lateral fields was slightly reduced and some patients were excluded from the treatment. Conclusions. Value of postoperative radiotherapy to decrease the incidence of local recurrence was confirmed in this retrospective study; the incidence of side effects was however considerable and did not support the addition of chemotherapy as advised by the NIH consensus meeting. Our policy was therefore moved to preoperative irradiation whose combination with chemotherapy was recently reported to be better tolerated and highly effective.

Neutron therapy of bladder carcinoma: can a high rate of severe complications be avoided in neutron therapy?

We reviewed retrospectively a series of 58 patients with deeply invasive bladder cancer treated with fast neutron therapy (p(65) + Be) in order to evaluate its tolerance and side effects. Patients were divided into three groups according to treatment technique. Patients of group A received whole pelvis irradiation up to 50 Gy photon equivalent followed by a boost to the bladder up to 57-66 Gy photon equivalent (40-56 days). Group B patients were treated by a split course regimen of 30 Gy photon equivalent on the whole pelvis at 3-4 weeks interval (66-108 days). Group C patients, not suitable for radical treatment, received only 40-54 Gy photon equivalent (26-70 days). The overall 5-year actuarial survival rate was 30% (SE 8%). As expected, T stage was a statistically significant prognostic factor. The overall local control rate reached 21% at 4 years. Acute and late side effects were minimal to moderate. These results suggest that high-energy neutron beam treatment is at least as effective as photon beam treatment for bladder carcinoma, without a higher incidence of major side effects.

Maxillary sinus carcinomas: natural history and results of postoperative radiotherapy

Between 1969 and 1985, 73 patients with maxillary sinus cancers underwent surgical excision and postoperative radiotherapy. The clinical stage distribution by the AJC system was 3 T 1, 16 T 2, 32 T 3, and 22 4. Six patients had palpable lymphadenopathy at diagnosis. Surgery for the primary tumor consisted of partial or radical maxillectomy, and if disease stage indicated it, ipsilateral orbital exenteration. This was followed by radiation treatment delivered through a wedge-pair or three-field technique. All but three patients received 50–60 Gy in 2 Gy fractions to an isodose line defining the target volume. Elective neck irradiation was not routinely given. Clinically involved nodes were treated with definitive radiotherapy (five patients) or combined treatment (one patient). Forty-five patients had no evidence of disease at the last follow-up. The 5-year relapse-free survival for the whole group was 51 % The overall local control rate was 78 %. Patients with larger tumors, particularly if they also had histological signs of nerve invasion, had a higher recurrence rate than others. The overall nodal recurrence rate without elective neck treatment was 38% for squamous and undifferentiated carcinoma, and only 5% for adenoid cystic carcinomas. Therefore, our current recommendation is to deliver elective nodal irradiation routinely to patients with squamous or undifferentiated carcinoma, except for those who have T 1 lesions. Treatment complications were vision impairment, brain and bone necrosis, trismus, hearing loss, and pituitary insufficiency. The incidence of major side effects was determined by disease extent and treatment technique. Many technical refinements were introduced in order to limit the dose to normal tissues in an attempt to reduce the complication rate. To what extent such practice influences the outcome will be determined from subsequent analysis.

Comparison of Complications Associated with Single-Holed and Multi-Holed Extradural Catheters

Adverse events associated with single-holed and multi-holed extradural catheters were compared in obstetric practice. Two hundred and forty-five patients were given an extradural block using a single-holed catheter and 229 received a block via a multi-holed catheter. There was no difference in the incidence of major side effects. Flow of fluid under gravity in the catheter was restricted significantly more often in the singleholed catheters. Blood was found significantly more often in the multi-holed catheters

Comparison of Complications Associated With Single-Holed and Multi-Holed Extradural Catheters

Adverse events associated with single-holed and multi-holed extradural catheters were compared in obstetric practice. Two hundred and forty-five patients were given an extradural block using a single-holed catheter and 229 received a block via a multi-holed catheter. There was no difference in the incidence of major side effects. Flow of fluid under gravity in the catheter was restricted significantly more often in the singleholed catheters. Blood was found significantly more often in the multi-holed catheters

Prevention of Cisplatin-Induced Vomiting in Patients with Cancer. A Pilot Study with a Multiagent Protocol

Forty patients receiving a total of 102 courses of cisplatin (CDDP)-based treatment were observed in the present study. The patients received an antiemetic prophylaxis with metoclopramide (6 mg/kg), dexamethasone (12 mg/m2), lorazepam (2.5 mg), promethazine (50 mg), and diazepam (10 mg). Complete protection from acute vomiting was obtained in 77.5% of patients during the first course, and partial protection (1 to 3 episodes of vomiting) was observed in 10.1% additional cases. Complete protection was achieved in 84.6% of males vs 57.1% of females. Patients at their first course of chemotherapy had 80% complete protection compared to 66.7% in those who received prior chemotherapy. No differences in the response rate between patients treated with high versus patients receiving low doses of CDDP were noted. The same pattern of response was observed in subsequent courses of therapy. Side effects were minimal (mild sedation in almost all the cases and hiccups in a few cases). No major extrapyramidal reaction was observed. The regimen used in the study showed good efficacy in preventing acute CDDP-induced nausea and vomiting. Moreover, the very low incidence of major side effects makes this protocol safe and recommendable in patients undergoing CDDP chemotherapy.

COMPARISON OF COMPLICATIONS ASSOCIATED WITH SINGLE-HOLED AND MULTI-HOLED EXTRADURAL CATHETERS

Adverse events associated with single-holed and multi-holed extradural catheters were compared in obstetric practice. Two hundred and forty-five patients were given an extradural block using a single-holed catheter and 229 received a block via a multi-holed catheter. There was no difference in the incidence of major side effects. Flow of fluid under gravity in the catheter was restricted significantly more often in the single-holed catheters. Blood was found significantly more often in the multi-holed catheters.

Anabolic steroid use by athletes. How serious are the health hazards?

Use of anabolic steroids is widespread in the athletic community, especially among power athletes, who have used them for about 30 years. Despite educational and preventive measures, steroid use has increased. Controversy continues regarding the enhancement of athletic performance and the incidence of major side effects. Some investigators have suggested that the hazards of anabolic steroids may be overstated in the diseased population and are minimal or absent in healthy subjects. Yet, many questions are unanswered. Current data do not link life-threatening side effects with intermittent use of anabolic steroids. However, many concerns remain. Dangerous situations include use of anabolic steroids by adolescents, preadolescents, and persons with liver or heart disease and use of oral compounds in high doses for long periods. A coordinated team approach (with representatives from sports, medicine, advertising, and the pharmaceutical industry) is needed to determine the real risks of anabolic steroids to athletes who are considering their use.

Adverse Reactions to Antiarrhythmic Drugs

To the Editor.— The article by Nygaard et al 1 contributes to the knowledge of limits and usefulness of antiarrhythmic drugs. However, we think that further insight into the problem might be derived from a more careful analysis of some cardinal points: Adverse effects and age: Age does not influence the incidence of major side effects when patients are grouped according to the cutoff point of 65 years. Such a conclusion is in agreement with several reports 2,3 regarding other kinds of drugs used in patients 65 to 75 years old. However, a larger incidence of major side effects in patients older than 70 to 75 years cannot be excluded in the absence of a comparison among at least three classes of patients (eg, those aged ≤ 40 years, 41 to 70 years, and > 70 years). This is especially important as regards neurological side effects, whose occurrence is

Adverse Reactions to Monoamine Oxidase Inhibitors. Part I. A Comparative Study

The incidence of major side effects of phenelzine and tranylcypromine is compared with that of imipramine and placebo medication in depressed outpatients. Psychiatric notes in the charts of 198 patients were reviewed. Based on clinical experience and literature review, 14 side effects were selected for study because of serious medical risk or subjective discomfort great enough to require drug discontinuation. Significant differences in risk for major side effects, as well as distinctive side effect profiles for each drug, were found. More side effects occurred on phenelzine, but these tended not to lead to drug discontinuation more often than with tranylcypromine, nor were they accounted for by differences in age, sex, diagnosis, or duration of treatment.