Antidepressant medications are often used in the treatment of major depression, anxiety disorders, and many other psychiatric conditions. They are most effective when used in combination with other treatments. By helping to alleviate troubling symptoms, they can help you live a more normal life. While taking a pill to help boost your mood or reduce anxiety sounds like an easy solution, there is a downside. Like all medications, antidepressants come with many potential side effects. That’s why it’s essential to consider carefully whether the benefits outweigh the risks. Following is a basic rundown of common antidepressant side effect of the four major groups of antidepressants.
SSRIs
The most frequently prescribed antidepressants on the market today belong to the category known as SSRIs – short for selective serotonin reuptake inhibitors. Not only are they quite effective for many people, they also generally have the most tolerable side effects. Brand names include Celexa, Lexapro, Prozac, and Zoloft. SSRIs work by targeting serotonin – one of the primary neurotransmitters that helps regulate mood. When your serotonin levels get too low, SSRIs help bring it back into balance by blocking or “inhibiting” its reabsorption. This, in turn, helps lift the cloud of depression. Common side effects of SSRIs include:
- Drowsiness
- Diarrhea
- Dry mouth
- Headache
- Increased sweating
- Nervousness or restlessness
- Rashes
- Diminished sexual desire
- Weight gain
While SSRIs are generally considered safe, they can interact with other drugs. For instance, the risk of bleeding increases if you take aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) with these antidepressants.
SNRIs
SNRI is short for serotonin and norepinephrine reuptake inhibitor. They work very similarly to SSRIs, except they target both serotonin and norepinephrine. Norepinephrine is another one of the brain’s chemicals that helps regulate your mood. Sometimes referred to as “duel reuptake inhibitors”, popular brand names in this category include Cymbalta, Effexor, and Pristiq. The most common side effects associated with SNRIs include:
- Changes in appetite
- Constipation
- Decreased sexual desire
- Difficult urination
- Dry mouth
- Excessive sweating
- Heart palpitations
- Insomnia
- Muscle weakness
- Tremors
If you’re pregnant (or considering becoming pregnant), nursing, or taking blood-thinning medications, make sure you discuss this with your doctor before taking SNRIs. Each type of SNRI carries its own risk of additional side effects. For instance, Cymbalta (known generically as duloxetine) can worsen liver problems. If you take this drug, your doctor may request periodic blood tests to be sure your liver continues to function properly. Pristiq (venlafaxine) can raise your blood pressure, which means your doctor may need to prescribe an additional medication to offset this side effect.
TCAs
TCA stands for tricyclic (and also tetracyclic) antidepressant. This type of antidepressant medication also helps your brain maintain appropriate levels of serotonin and norepinephrine. Before SSRIs and SNRIs became available, TCAs were the most commonly prescribed antidepressant medications. However, some of the challenging side effects often associated with them – particularly weight gain and significant dry mouth- made them undesirable for many individuals. Some of the most common generic TCAs include amitriptyline, doxepin, imipramine, and nortriptyline. A particular challenge with TCA antidepressants is that they also affect other naturally-occurring brain chemicals, leading to a host of potential side effects. Some of these side effects include:
- Blurred vision
- Drowsiness
- Constipation
- Increase in appetite
- Weight gain
- Dizziness
- Elevated heart rate
- Low blood pressure
- Diminished sex drive
- Delayed orgasm
- Nausea
- Seizures
- Sensitivity to sunlight
Each TCA is different, so they won’t all cause the same side effects. For example, desipramine may cause you to feel sleepier than other tricyclic medications. This may be beneficial when insomnia is a problem, but if the drowsiness is problematic then another TCA may be a better option. You’ll need to take special care if you take these drugs while living with diabetes. They are known to affect blood sugar, so you will need to check blood sugar levels more often. If you are pregnant, considering becoming pregnant, or nursing, be sure to discuss this with you doctor before taking this type of antidepressant. An overdose of most TCAs can be lethal. This is always a risk that must be carefully considered when prescribed to anyone with severe depression or a history of suicidal behavior.
MAOIs
Of all the types of antidepressants, MAOIs – while very effective – can trigger some of the most serious side effects. These include serotonin syndrome, dangerous interactions with certain foods and beverages, and also dangerous interactions with other medications and supplements. This is why they’re often only prescribed when other antidepressants have failed. MAOI is short for monoamine oxidase inhibitor. Monoamine oxidase is an enzyme that depletes the brain’s naturally-occurring “feel-good” chemicals, such as serotonin, dopamine, and norepinephrine. MAOIs help alleviate symptoms of depression by preventing the removal of these neurotransmitters that play such a vital role in mood regulation. Some of the more commonly prescribed MAO inhibitors include Marplan, Nardil, and Parnate. Common side effects of MAOIs include:
- Altered sense of taste
- Decreased sexual desire
- Difficult urination
- Dizziness or lightheadedness
- Diarrhea
- Insomnia
- Low blood pressure
- Muscle aches
- Nervousness
- Weight gain
In addition to potentially serious side effects, other considerations sometimes play a role in whether a doctor prescribes MAO inhibitors. For example, since they may harm an unborn child, they’re prescribed to pregnant women only when absolutely necessary. Certain types of medications and supplements, including other types of antidepressants, can also interact dangerously with MAOIs. Always inform your doctor of any supplements or other medications you’re taking, even over-the-counter (OTC). Serotonin syndrome is a rare but serious side effect that may occur when taking an MAOI along with another medication or supplement that boosts serotonin levels. MAOIs interact dangerously with foods and beverages that are especially high in the amino acid tyramine. High levels of tyramine in the body can cause dangerous elevations in blood pressure. Beer, wine, soy products, aged cheeses, sauerkraut, brewer’s yeast, and cured meats are some of the foods and beverages that must be avoided.
Other Important Considerations with Antidepressants
Typically, antidepressant medication is prescribed only when symptoms of depression are serious enough to interfere with your life. Mild to moderate depression can sometimes be very effectively treated without medication. Regardless, for maximum relief, you’ll need to incorporate other treatment strategies, such as attending talk therapy and making lifestyle changes that will help improve your mood. Taking antidepressants must always be done under the supervision of a qualified medical provider, preferably a mental health professional. You’ll need to closely follow your prescriber’s instructions about when and how to take the antidepressant. Antidepressants have the potential to increase the risk of suicide, especially in children, teens, and young adults. When you start taking one of these drugs, be on alert for any signs that your depression is getting worse. If it does – and especially if you have thoughts of suicide – contact your doctor or therapist immediately. The antidepressant side effects listed here represent some of the most common. However, these lists are far from comprehensive with regards to all the potential side effects associated with antidepressants. Always consult your doctor for a full list of potential side effects and drug interactions. Every person is different with regards to how a medication affects them; the side effects you experience from a particular medication may be quite different than someone else’s. If you start taking an antidepressant, understand that it may take several weeks to notice a difference in your symptoms. Antidepressants do not produce quick results like pain relievers or benzodiazepines (used to treat anxiety). Your doctor may also start you on a low dose at first and slowly increase it to a “therapeutic level”. It’s also important to remember that some side effects are more pronounced at first and diminish with time as your body adjusts to the medication. Not every antidepressant will work for every patient. Be prepared to try a few before finding one that makes your symptoms manageable with the least amount of side effects. In some cases, your prescriber may recommend a combination of antidepressants (or add another medication) in order to enhance the effectiveness. Never change your dosage or stop taking any antidepressant without consulting with your doctor first. Abruptly stopping some antidepressants, like MAOIs or certain SSRIs, cold turkey can cause very unpleasant withdrawal-type symptoms. Instead, work with your doctor to gradually taper the dosage over time.
Which antidepressant is right for you?
Finding the right antidepressant may involve some trial and error. The most effective way to find one that’s likely to work well for you is to team up with a mental health professional experienced in treating depression. Together you can find the right combination of medication, therapy, and lifestyle changes that will help you live a life that’s free from depression.