Psychotropic Tolerability Comparison: Side Effects

What it compares

Pick two, three or four medications and see their relative side-effect profiles side by side. The library holds 51 agents: SSRIs, SNRIs, vilazodone and vortioxetine, tricyclics, MAOIs, bupropion, mirtazapine, trazodone, gepirone, dextromethorphan-bupropion, esketamine, brexanolone and zuranolone, and first- and second-generation antipsychotics. The tool sits alongside Med Comparison and Binding Profiles under the Binding and Comparison tabs.

Clinician view

Each drug is placed on a five-step scale (none, minimal, low, moderate, high) for five domains: weight gain, sedation, sexual effects, anticholinergic effects (dry mouth, constipation) and QTc. Numbered markers show where each selected drug falls on the same track. Below the tiers, a class safety and monitoring box lists key risks for each class selected, such as the antidepressant suicidality boxed warning, serotonin syndrome and bleeding risk, SNRI blood pressure effects, MAOI tyramine interactions, bupropion seizure risk, and antipsychotic metabolic, EPS, NMS and dementia-mortality warnings. For curated pairs (currently levomilnacipran and milnacipran) the view adds an at-a-glance table, documented incidence from registration trials, and clinical pearls.

Patient view

A second view turns the same comparison into a plain-language handout for chairside discussion. It drops the QTc and anticholinergic jargon, shows weight gain, sleepiness and sexual side effects as how often they tend to happen (uncommon, sometimes, fairly common, common), and lists take-home safety points such as not stopping suddenly and which warning signs need prompt care.

Copying and limitations

Copy formatted puts the comparison on the clipboard as a table that pastes into documents and notes, with a plain-text fallback. Tiers are relative, not absolute: they are dose- and patient-dependent estimates of burden relative to other psychotropics, synthesized from prescribing guidelines, network meta-analyses and FDA labeling, and they are not incidence rates for an individual. QTc risk is further changed by electrolytes, interacting drugs and cardiac history. Use the tool alongside full prescribing information and clinical judgment.