Antidepressants are medications primarily used to treat depression, anxiety disorders, obsessive-compulsive disorder, and chronic pain. They influence neurotransmitters, chemical messengers in the brain that regulate mood and emotions. The goal is to alleviate symptoms, restore emotional balance, and improve overall well-being.
Antidepressant Categories and Their Common Side Effects
Antidepressants are grouped into categories with distinct mechanisms and side effects. Selective serotonin reuptake inhibitors (SSRIs) are frequently prescribed. Common SSRI side effects include nausea, headache, sleep disturbances, sexual dysfunction (e.g., decreased libido), appetite changes (weight gain or loss), and increased anxiety or restlessness.
Serotonin-norepinephrine reuptake inhibitors (SNRIs) affect both serotonin and norepinephrine. Side effects include nausea, dry mouth, dizziness, and sleep disturbances. Less commonly, SNRIs can cause increased blood pressure or liver problems. Tricyclic antidepressants (TCAs) are an older class with a broader range of side effects, such as dry mouth, blurred vision, constipation, urinary retention, weight gain, drowsiness, and a rapid heart rate.
Monoamine oxidase inhibitors (MAOIs) are an older class, reserved due to dietary restrictions and potential for serious interactions. Common MAOI side effects include drowsiness, insomnia, dry mouth, nausea, diarrhea, constipation, dizziness, sexual dysfunction, and weight gain. Atypical antidepressants, like bupropion, increase norepinephrine and dopamine. Their common side effects include sleep disturbances, headaches, irritability, dry mouth, constipation, and appetite changes (loss or weight loss).
Strategies for Managing Common Side Effects
Managing common antidepressant side effects involves practical adjustments and communication with a healthcare provider. Nausea can be lessened by taking medication with food or eating smaller, frequent meals. Drinking plenty of fluids helps alleviate dry mouth. If drowsiness occurs, taking the antidepressant at bedtime or engaging in light physical activity may be beneficial.
For sleep disturbances, taking medication in the morning and avoiding late-day caffeine can help. Weight gain can be addressed through dietary changes and increased physical activity. Sexual side effects can sometimes be managed by timing medication around sexual activity or discussing alternatives with a healthcare provider. Always consult a healthcare provider before changing medication dosage or timing.
Recognizing Serious or Concerning Side Effects
While many antidepressant side effects are mild, some are serious and require immediate medical attention. Serotonin syndrome is a rare, life-threatening condition caused by excess serotonin, often when combined with other serotonin-increasing drugs or supplements. Symptoms can appear within hours, including nervousness, nausea, vomiting, diarrhea, dilated pupils, muscle twitching or rigidity, sweating, shivering, confusion, and a rapid heartbeat. Immediate medical help is necessary if these symptoms occur.
Antidepressants can sometimes increase suicidal thoughts or behaviors, particularly in children, adolescents, and young adults under 25, especially during initial treatment or after a dose change. Report any new or worsening suicidal thoughts, severe agitation, or unusual behavioral changes to a healthcare provider immediately. Severe allergic reactions, though rare, can manifest as hives, swelling, or difficulty breathing and warrant emergency care. Hyponatremia (low sodium levels), a rare concern particularly in older adults, can cause headaches, confusion, drowsiness, and seizures, typically within the first two to four weeks of starting an antidepressant.