Antidepressants: Get tips to cope with side effects – Mayo Clinic

Most antidepressant side effects aren’t dangerous, but they can be bothersome. Here’s what to do.

Antidepressants can cause unpleasant side effects. Signs and symptoms such as nausea, weight gain or sleep problems can be common initially. For many people, these improve within weeks of starting an antidepressant. In some cases, however, antidepressants cause side effects that don’t go away.

Talk to your doctor or mental health professional about any side effects you’re having. For some antidepressants, monitoring blood levels may help determine the range of effectiveness and to what extent dosage can be adjusted to help reduce side effects. Rarely, antidepressants can cause serious side effects that need to be treated right away.

If side effects seem intolerable, you may be tempted to stop taking an antidepressant or to reduce your dose on your own. Don’t do it. Your symptoms may return, and stopping your antidepressant suddenly may cause withdrawal-like symptoms. Talk with your doctor to help identify the best options for your specific needs.

Nausea typically begins early after starting an antidepressant. It may go away after your body adjusts to the medication.

Consider these strategies:

Increased appetite, weight gain

You may gain weight because of fluid retention or lack of physical activity, or because you have a better appetite when your depression symptoms ease up. Some antidepressants are more likely to cause weight gain than others. If you’re concerned about weight gain, ask your doctor if this is a likely side effect of the antidepressant being prescribed and discuss ways to address this issue.

Consider these strategies:

Fatigue, drowsiness

Fatigue and drowsiness are common, especially during early weeks of treatment with an antidepressant.

Consider these strategies:

Some antidepressants may cause insomnia, making it difficult to get to sleep or stay asleep, so you may be tired during the day.

Consider these strategies:

Dry mouth

Dry mouth is a common side effect of many antidepressants.

Consider these strategies:

Constipation is often associated with tricyclic antidepressants because they disrupt normal functioning of the digestive tract and other organ systems. Other antidepressants sometimes cause constipation as well.

Consider these strategies:

Dizziness is more common with tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) than with other antidepressants. These medications can cause low blood pressure, resulting in dizziness.

Consider these strategies:

Agitation, restlessness, anxiety

Agitation, restlessness or anxiety can result from the stimulating effect of certain antidepressants. Although having more energy can be a good thing, it may mean you can’t relax or sit still even if you want to.

Consider these strategies:

Be alert for racing or impulsive thoughts along with high energy. If these develop, talk to your doctor right away because they may be signs of bipolar disorder or another serious disorder.

Sexual side effects

Many antidepressants cause sexual side effects. They can include reduced sex drive and difficulty reaching orgasm. Some antidepressants may cause trouble getting or keeping an erection (erectile dysfunction). Selective serotonin reuptake inhibitors (SSRIs) are more likely to cause sexual side effects than other antidepressants are.

Consider these strategies:

Heart-related effects

Depending on your heart health and the type of antidepressant you take, you may need an electrocardiogram (ECG) before or periodically during treatment. The ECG is used to monitor what’s called the QT interval to make sure it’s not prolonged. A prolonged QT interval is a heart rhythm condition that can increase your risk of serious irregular heart rhythms (arrhythmias).

Certain antidepressants should not be used if you already have heart problems or if you’re taking an MAOI. Talk with your doctor about your heart health and any heart medications or other medications that you take.

Genetic variations

Some studies indicate that variations in genes may play a role in the effectiveness and risk of side effects of specific antidepressants. So your genes may, at least in part, determine whether a certain antidepressant will work well for you and whether you’re likely to have certain side effects.

Some locations already provide limited genetic testing to help determine antidepressant choice, but testing is not routine and it’s not always covered by insurance.

More studies are being done to determine what might be the best antidepressant choice based on genetic makeup. However, genetic testing is a part of — not a replacement for — a thorough psychiatric exam and clinical decisions.

  1. Simon G, et al. Unipolar major depression in adults: Choosing initial treatment. Accessed Aug. 23, 2019.
  2. Tarleton EK, et al. Primer for nutritionists: Managing the side effects of antidepressants. Clinical Nutrition ESPEN. 2016; doi:10.1016/j.clnesp.2016.05.004
  3. Mental health medications. National Institute of Mental Health. Accessed Aug. 23, 2019.
  4. Morgan AJ, et al. Self-help strategies for sub-threshold anxiety: A Delphi consensus study to find messages suitable for population-wide promotion. Journal of Affective Disorders. 2018; doi:10.1016/j.jad.2016.07.024.
  5. Nassan M, et al. Pharmacokinetic pharmacogenetic prescribing guidelines for antidepressants: A template for psychiatric precision medicine. Mayo Clinic Proceedings. 2016; doi:10.1016/j.mayocp.2016.02.023.
  6. LeBlanc A, et al. Shared decision making for antidepressants in primary care: A cluster randomized trial. JAMA Internal Medicine. 2015; doi:10.1001/jamainternmed.2015.5214.
  7. Hirsch M, et al. Selective serotonin reuptake inhibitors: Pharmacology, administration, and side effects. Accessed Aug. 23, 2019.
  8. Celexa (prescribing information). Allergan USA, Inc.; 2017. Accessed Aug. 27, 2019.
  9. Dry mouth. National Institute of Dental and Craniofacial Research. Accessed Aug. 26, 2019.
  10. Kahl KG, et al. Effects of psychopharmacological treatment with antidepressants on the vascular system. Vascular Pharmacology. 2017; doi:10.1016/j.vph.2017.07.004.
  11. Wang S-M, et al. Addressing the side effects of contemporary antidepressant drugs: A comprehensive review. Chonnam Medical Journal. 2018; doi:10.4068/cmj.2018.54.2.101.
  12. Postural hypotension: What it is and how to manage it. Centers for Disease Control and Prevention. Accessed Aug. 26, 2019.
  13. Constipation. Merck Manual Professional Version. Accessed Aug. 26, 2019.
  14. Tainted sexual enhancement products. U.S. Food and Drug Administration. Accessed Aug. 27, 2019.
  15. Approach to the patient with a sleep or wakefulness disorder. Merck Manual Professional Version. Accessed Aug. 26, 2019.
  16. AskMayoExpert. Chronic fatigue. Mayo Clinic; 2018.
  17. Francois D, et al. Antidepressant-induced sexual side effects: Incidence, assessment, clinical implications, and management. Psychiatric Annals. 2017; doi:10.3928/00485713-20170201-01.
  18. Losing weight: Getting started. Centers for Disease Control and Prevention. Accessed Aug. 26, 2019.
  19. FDA drug safety communication: Revised recommendations for Celexa (citalopram hydrobromide) related to a potential risk of abnormal heart rhythms with high doses. U.S. Food and Drug Administration. Accessed Aug. 27, 2019.
  20. Dietary supplements: What you need to know. NIH Office of Dietary Supplements. Accessed Aug. 27, 2019.
  21. Hall-Flavin DK (expert opinion). Mayo Clinic. Aug. 28, 2019.

This content was originally published here.

%d bloggers like this: