Antidepressants can ease many symptoms of depression, but side effects are often part of the package. Some side effects are tough to deal with, while others you can manage. In rare cases, they can be serious and your doctor may need to change your medication.
The key is to talk with your doctor about any antidepressant side effects that bother you. Your doctor can help you get relief and change your treatment plan if needed. “We’re going off of what the patient is telling us, and then based on that information we can make an appropriate recommendation,” says Stephen Ferber, MD, assistant director of the Psychiatric Treatment-Resistance Program at the Cleveland Clinic.
Most Common Antidepressant Side Effects
Everyone reacts to medicines differently, but some side effects are common. These include:
- Nausea
- Weight gain
- Trouble sleeping
- Dry mouth
- Blurred vision
- Dizziness
- Anxiety
- Headache
- Diarrhea or constipation
- Sexual problems
- Fatigue
- Tremors
- Increased sweating
You may have many, a few, or none of these. Remember, some of these may go away in a few weeks after you start your antidepressant. Most of the common side effects last a short time, Ferber says. But some, such as sexual troubles, can be long-term while you’re on medication, he adds. Ask your doctor for help if you have any sexual side effects.
Lesser-Known Antidepressant Side Effects
Some other side effects from antidepressants aren’t discussed as often. But they’re still important to look out for. They may include:
Lower alcohol tolerance. Try drinking alcohol more slowly and drinking less as you get used to your antidepressant. There may be an extra sedative effect when you combine the two.
Bleeding. Antidepressants, particularly SSRIs, can affect platelet clotting and raise your risk of bleeding. Watch out for new, easy bruising or nosebleeds, especially if you have a history of bleeding in your gut.
Lower sodium levels. Sometimes, antidepressants can interfere with your blood sodium level, which can cause headaches or confusion. Low sodium levels, called hyponatremia, are more common in older people. The risk is also a lot higher in the first two to four weeks after you start an antidepressant.
Watch for symptoms of hyponatremia when you’re adjusting to a new antidepressant. Along with headaches and confusion, these include:
- Nausea
- Vomiting
- Drowsiness
- Fatigue
- Crankiness
- Restlessness
- Muscle cramps, spasms, or weakness
- Seizures
Call your doctor if you notice these symptoms.
Who Gets Side Effects From Antidepressants?
Everyone reacts differently to medication. Side effects can vary even among those taking the same medicine. But some people don’t notice any problems.
Things that may affect how you respond to antidepressants include:
Other medications. Some drugs might interact with your antidepressant. You may have more side effects if your other medications boost the effectiveness of your antidepressant. On the other hand, some medications may cause your antidepressant to be less effective. This is why it’s important to make sure that all your health care providers have a complete list of the medications you’re taking, both prescription and over-the-counter.
Age. Older people are more likely to have some kind of side effect.
Genes. Your genes affect the way your body handles drugs. For example, if your body absorbs medication slowly, you may be more prone to side effects.
The type of drug. Older antidepressant medications, such as tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs), tend to have more side effects than SSRIs, SNRIs, and atypical antidepressants.
Dealing With Side Effects From Antidepressants
Here are some general things that can help you ease side effects when taking your antidepressants:
- Eat small, more frequent meals throughout the day to help your digestion.
- Drink plenty of water.
- Cut back on sweets and saturated fats.
- Eat plenty of veggies and fruits.
- Keep a food diary so you can see if something you’re eating is worsening your side effects.
- Practice relaxation methods, such as deep breathing or yoga.
- Get regular exercise.
Depending on your side effects, there are specific things that can help:
Nausea. Suck on sugarless candy, and ask about a slow-release version of your antidepressant. Take the medication at night so the nausea doesn’t bother you as much. You can also ask your doctor if taking anti-nausea medication might help you, Ferber says.
Sexual issues. Have sex right before you take your antidepressant, when its effects are lowest. Talk to your doctor about other things that can help, such as estrogen cream or erectile dysfunction medication. You can also ask your doctor if an occasional “drug holiday” might be right for you, Ferber says. That’s when you skip taking your medication for a couple of days, usually over the weekend, he says.
Fatigue. Take your meds at night before bed. Try to have a short nap during the day, too.
Trouble sleeping. Take your antidepressant in the morning instead of close to bedtime, stay away from caffeine, and ask your doctor about any medicines that can help you sleep.
Dry mouth. Carry water with you throughout the day, and suck on ice chips or chew gum. Try to breathe through your nose instead of your mouth. Talk to your doctor about medication that can help you make more saliva.
Blurred vision. Ask your doctor about special eyedrops that can moisten your eyes.
Constipation. Eat plenty of high-fiber foods, or take a fiber supplement. Stool softeners can help, too.
Dizziness. Move slowly, especially when standing up. Take your antidepressant at bedtime.
Treatment Effects That Aren’t Physical
These may include:
Disliking medication. Some people hate having to take medicine to feel better. This can lead to not taking it as prescribed or quitting it altogether. Ferber suggests talking to your doctor about the risks, benefits, and alternatives of medication and how it fits into your lifestyle — especially because medication isn’t the only recommended treatment for depression.
Emotional blunting. You may notice that you feel emotionally numb when you take an antidepressant. Unfortunately, this is a common side effect. To manage it, you might try:
- Talking to a therapist about ways to boost your mood
- Asking your doctor about lowering your antidepressant dose
- Taking part in activities that boost serotonin, such as exercise, massage therapy, and light therapy
- Not relying on medication alone. Lots of people use antidepressants as their only treatment for depression. But when you’re depressed, there may be something you need to talk about or work on in psychotherapy. This is why it’s an important part of depression treatment.
When to Call Your Doctor
Some side effects are serious. If you have any of these symptoms, tell your doctor right away:
- Thoughts about or attempts at suicide
- More feelings of depression and anxiety
- Feeling very agitated or restless
- Panic attacks
- Trouble sleeping
- New or worsening crankiness
- Aggression or violence
- Hallucinations
- Acting out dangerous impulses
- Feeling hyperactive
- Other unusual changes in behavior or mood
Sometimes, antidepressants can mix with other medicines and pose life-threatening problems. Pay close attention to any new symptoms or ones that get worse.
Making a Switch
If the side effects of your current antidepressant are too much, talk to your doctor about a change. It’s important not to stop taking your antidepressant without talking to your doctor first. Quitting it suddenly can cause withdrawal symptoms or worsen your depression.
When you switch, your doctor will decide on the best method to avoid withdrawal. Also, they will watch you closely while you go through this process.
There are many ways to change your medicine, including:
Conservative switch
- You’ll gradually lower your dose of your current antidepressant until you stop.
- You won’t take any medication for a specific number of days.
- After that, you’ll start your new medicine at the recommended dose.
Moderate switch
- You’ll gradually lower the dose of your current antidepressant until you stop.
- You won’t take any medication for a specific number of days.
- Next, you’ll start the new medication at a low dose and raise it gradually.
Direct switch
- You’ll stop your current antidepressant.
- The next day, you’ll start the new antidepressant at full dose.
Cross-taper switch
- You’ll gradually lower the dose of your current antidepressant until you stop.
- As your old antidepressant dose goes down, you’ll start taking the new antidepressant at a low dose.
- You’ll take more of the new antidepressant and less of the old one until you stop the first and reach a full dose of the second.
Only your doctor can decide which of these methods is right for you.
Talk to Your Doctor Before Stopping an Antidepressant
Quitting your antidepressant suddenly can be physically uncomfortable, especially if you’ve been on it for a while. And if you’ve been taking a higher dose, you can get something called discontinuation syndrome. As the medication leaves your body, you start getting headaches or flu-like symptoms.
Stopping your medication also raises the chance of your depression symptoms returning. You may feel better now that you’re taking it, but this doesn’t mean you don’t need it anymore. You’ll need to keep taking your antidepressant to prevent a relapse.
If the side effects are too much, talk with your doctor. Remember, the first medicine you try may not be the right one for you. It might take some trial and error to find which antidepressant and dose work best for you.
You may get to a point where you want to stop your medication. Talk to your doctor first. That way, you can discuss other treatment options and agree on a schedule to slowly lower the medicine dose to keep discomfort to a minimum.
Takeaways
Depression medicines called antidepressants can cause side effects. Some common side effects are nausea, weight gain, sexual problems, and trouble sleeping. Certain side effects go away on their own, while others need to be managed by your doctor. Work together to take charge of any serious side effects, and don’t stop taking your medicine without your doctor’s help.
Antidepressant Side Effects FAQs
Do antidepressants have serious side effects?
Sometimes, antidepressants can cause serious side effects. These can include suicidal thoughts or attempts, more feelings of depression and anxiety, severe agitation or restlessness, panic attacks, aggression or violence, hallucinations, and unusual mood changes. Tell your doctor right away if you have any of these or other side effects that worry you.
What are the side effects of antidepressants in females?
Some research shows that tremors, lower sex drive, and trouble reaching orgasm are slightly more common in females than in males, Ferber says. But these differences between the sexes aren’t large enough to be clinically meaningful, he believes.
What are the benefits of stopping antidepressants?
The only benefit of stopping an antidepressant with your doctor’s help would be to get rid of a serious or very distressing side effect, Ferber says. If your antidepressant doesn’t cause you side effects, there’s no benefit to stopping it, he says. That’s because your depression could come back after you get off of your medication.
What are the side effects of the antidepressant Effexor?
Some of Effexor’s more common side effects are unusual dreams, constipation, diarrhea, dry mouth, heartburn, nausea or vomiting, trouble sleeping, and reduced sexual desire or ability. Less common side effects can include blurred vision, chest pain, changes in mood or mental state, and suicidal thoughts. Get medical help right away if you have any of these.
When do antidepressant side effects start?
The timing varies. It’s possible to have side effects after your first dose of an antidepressant, Ferber says. But side effects tend to reach their peak in the second week of antidepressant use and then gradually become less frequent from there, he says.
