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Antidepressant Side Effects: What are They and How to Cope With Them

Antidepressant Side Effects: What are They and How to Cope With Them

In order to find relief from common mental health conditions like depression and anxiety, many people turn to medications called antidepressants. Approximately 12.7 percent of people ages 12 and older report using antidepressants within the past month, which speaks to how commonly people experience depression in our society. Although antidepressants help reduce the symptoms of depression and certain types of anxiety, they also have many side effects, some of which can be especially bothersome. There are five different types of antidepressants, each with their own unique side effects. Despite their tendency to cause side effects, antidepressants are among the most widely prescribed medications in the United States due to their effectiveness in treating depression. 

What are the symptoms of depression?

Depression is one of the most common mental health conditions and is experienced by people of all ages. When people experience depression, they commonly have intense feelings of sadness, a loss of interest in activities that they typically enjoy, and symptoms that interfere with their quality of life for two weeks or more. Everyone experiences ups and downs and feelings of happiness and sadness, but depression is marked by a pervasive feeling of sadness or emptiness that lasts for an extended period of time. The physical, emotional, and mental symptoms of depression are different from person to person and vary in intensity depending on the individual. Depression can be caused by a number of different genetic, psychological, biological, and environmental factors. Common symptoms of depression include:

  • Persistent sadness
  • Feelings of hopelessness or pessimism
  • Persistent anxiety
  • Irritability
  • Pains
  • Decreased energy
  • A loss of interest in hobbies
  • Reduced libido
  • Fatigue
  • Difficulty concentrating
  • Digestive problems
  • Suicidal thoughts
  • Aches
  • Suicide attempts
  • Change in appetite

What are antidepressants and what are the different types?

Antidepressants are one of the top three most commonly prescribed classes of drugs in the United States. These medications are commonly used to treat depression, but some may be used to treat other mental health conditions, such as certain forms of anxiety. Antidepressants are not considered a cure for depression, but they can help to reduce the symptoms of depression. Antidepressant medications act on certain chemicals in the brain, including serotonin, norepinephrine, and dopamine. These neurotransmitters are responsible for communicating messages between brain cells, and when the natural balance of the brain’s chemistry is off track, depression and other mental disorders can occur. There are five main types of antidepressants, including selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), atypical antidepressants, tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs).

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are the most commonly prescribed type of antidepressants. These drugs are generally associated with a lower risk of side effects than other types of antidepressants, and they may also cause fewer problems when prescribed at high doses. Popular SSRIs include:

  • Prozac (fluoxetine)
  • Paxil (paroxetine)
  • Zoloft (sertraline)
  • Celexa (citalopram)
  • Lexapro (escitalopram)
  • Luvox (fluvoxamine)
  • Pexeva (paroxetine mesylate)
  • Trintellix (vortioxetine)

Serotonin and norepinephrine reuptake inhibitors (SNRIs)

SNRIs are a new class of antidepressants that act on both serotonin and norepinephrine in the brain. They are a newer type of antidepressant and have grown in popularity in recent years. Popular SNRIs include:

  • Cymbalta (duloxetine)
  • Effexor XR (venlafaxine)
  • Pristiq (desvenlafaxine)
  • Fetzima (levomilnacipran)

Tricyclic antidepressants

Tricyclic antidepressants are an older class of antidepressants and typically cause more side effects than newer forms of antidepressants. Most doctors do not prescribe tricyclic antidepressants unless a patient has tried other antidepressants first without seeing improvement. Common tricyclic antidepressants include:

  • Tofranil (imipramine)
  • Pamelor (nortriptyline)
  • Amitriptyline
  • Doxepin
  • Norpramin (desipramine)

Atypical antidepressants

Atypical antidepressants are antidepressants that do not belong to another class of antidepressants. These medications work differently than other types of antidepressants and have different side effects. Common atypical antidepressants include:

  • Wellbutrin (bupropion)
  • Trazodone
  • Trintellix (vortioxetine)
  • Viibryd (vilazodone)

Monoamine oxidase inhibitors (MAOIs)

MAOIs are among the earliest forms of antidepressants. Due to their risk of serious side effects and dangerous, potentially deadly interactions with certain types of foods, drinks, and medications, doctors typically do not prescribe MAOIs to patients unless other medications have not been effective. 

What side effects are commonly associated with antidepressants?

Each type of antidepressant has different side effects that are commonly associated with its specific drug class, and within each drug class, each medication has slightly different side effects. However, some side effects are common for all or most medications within a drug class.

Common side effects of SSRIs include:

  • Feeling agitated, shaky, or anxious
  • Indigestion
  • Loss of appetite and weight loss
  • Blurred vision
  • Excessive sweating
  • Headaches
  • Difficulty achieving orgasm during sex or masturbation
  • Low sex drive
  • Erectile dysfunction in men
  • Feeling or being sick
  • Diarrhea or constipation
  • Dizziness
  • Dry mouth
  • Difficulty falling asleep (insomnia)
  • Drowsiness

Common side effects of SNRIs include:

  • Nausea
  • Dizziness
  • Excessive sweating
  • Dry mouth
  • Headache
  • Tiredness
  • Insomnia
  • Loss of appetite
  • Constipation
  • Changes in sexual desire
  • Difficulty achieving orgasm
  • Erectile dysfunction

Common side effects of tricyclic antidepressants include:

  • Drowsiness
  • Constipation
  • Drop in blood pressure when moving from sitting to standing
  • Blurred vision
  • Dry mouth
  • Urine retention
  • Weight loss
  • Excessive sweating
  • Sexual problems, including difficulty achieving an erection or low sex drive
  • Increased appetite leading to weight gain
  • Tremors

Common side effects of MAOIs include:

  • Dry mouth
  • Headache
  • Insomnia
  • Skin reaction at the patch site
  • Nausea
  • Constipation
  • Diarrhea
  • Drowsiness
  • Dizziness or lightheadedness
  • Involuntary muscle jerks
  • Reduced sexual desire or difficulty achieving orgasm
  • Difficulty urinating
  • Prickling or tingling sensation in the skin
  • Low blood pressure
  • Weight gain
  • Muscle cramps

How can side effects associated with antidepressants be minimized or avoided?

Although antidepressants come with a long list of side effects, many people rely on the medication to improve their depression or anxiety, which means that quitting the medication is not an option. Fortunately, it is possible to mitigate or avoid some common side effects associated with different types of antidepressants.

  • Nausea: Take your medication with food, eat small meals more frequently, and drink plenty of fluids
  • Fatigue and drowsiness: Get in some form of physical activity, such as going for a brisk walk; take a nap during the day if needed; take your medication at bedtime
  • Insomnia: Take your medication in the morning; avoid caffeinated food and drinks; get regular exercise that ends several hours before bedtime
  • Constipation: Drink lots of water, eat foods with plenty of fiber, get regular exercise, and take a fiber supplement
  • Dry mouth: Drink plenty of water; breathe through your nose; avoid tobacco, alcohol, and caffeine; brush your teeth twice daily
  • Sexual side effects: Engage in sexual activity before taking your medication dose, communicate with your partner about sexual side effects and necessary changes in routine, consider adding a medication that can improve sexual side effects, such as Viagra
  • Increased appetite and weight gain: Reduce your intake of sugar, count your calories and track your food, get regular exercise, and fill up on fruits, vegetables, and other healthy snacks that are high in fiber
  • Dizziness: Get up slowly from a sitting or lying position; avoid using caffeine, alcohol, or tobacco; drink lots of water; take your antidepressant at bedtime; use handrails or other sturdy items for support
  • Restlessness and anxiety: Get regular exercise, practice deep-breathing or mindfulness exercises, and practice meditation
  • Sources:

    https://www.healthline.com/health/erectile-dysfunction/antidepressant-sexual-side-effects#causes 

    https://www.verywellmind.com/how-to-reduce-sexual-side-effects-1067490 

    https://www.health.harvard.edu/womens-health/when-an-ssri-medication-impacts-your-sex-life 

    https://www.medicalnewstoday.com/articles/315984#How%20antidepressants%20cause%20sexual%20side%20effects 

    https://www.nhs.uk/conditions/ssri-antidepressants/side-effects/ 

    https://www.aafp.org/afp/2000/0815/p782.html 

    https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20044970 

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    https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046983 

    https://www.webmd.com/depression/drug-side-effects#1 

    https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20049305