Last Updated on September 28, 2022 by Dr.Derek Fhisher
Most side effects of antidepressants are not dangerous, but they can be bothersome.
Antidepressants can cause unpleasant side effects. Symptoms and signs such as nausea, weight loss, or trouble sleeping may be common. They worsen in many people several months after starting an antidepressant. In some cases, antidepressants cause unwanted effects that don’t go away on their own. Talk to your doctor or health care provider about any side effects you are experiencing. For many antidepressants, monitoring blood glucose levels can help determine how much you can adjust your dose to reduce side effects and determine the effectiveness of your drug of choice. In rare cases, antidepressants can cause side effects that require immediate treatment. If the side effects seem intolerable, you may want to reduce the dose or stop taking an antidepressant. Do not do this. Your symptoms may return, and abruptly stopping an antidepressant can cause symptoms. Consult your doctor to determine the best option.
Antidepressants can cause symptoms such as nausea, loss of appetite, or vomiting. These symptoms may be serious or mild and may happen for a few days or for months. If you lose more than 5% of your body weight, stop taking the antidepressant. If nausea or vomiting becomes severe, ask your doctor about changes in the medication, dosage, or timing of the dose. For people who stop taking antidepressants suddenly, the symptoms can return. Contact your doctor or health care provider as soon as you begin to experience them. Antidepressants that can cause nausea and vomiting include:
- Imipramine (Tofranil)
- Paroxetine (Paxil)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs) (e.g., Cymbalta, Effexor)
- Sertraline (Zoloft)
- Tranylcypromine (Parnate)
In people taking fluoxetine (Prozac) or other medications that contain fluoxetine, it may not be possible to reverse the nausea and vomiting caused by these drugs. This may result in weight loss. The weight loss may persist even if the medication is stopped. Consult your doctor if you lose more than 5% of your body weight.
Antidepressants are sometimes prescribed to treat symptoms of depression in people who have diabetes, especially when the depressive symptoms are part of a major depressive episode. Serotonin-norepinephrine reuptake inhibitors (SNRIs) are the most commonly prescribed antidepressants for this purpose. In the short-term, they may cause blood glucose levels to decrease. This effect may not be observed in people with normal blood glucose levels. Over the long term, some antidepressants have been shown to cause elevated glucose levels, although others do not appear to cause these effects. Some SNRIs have been shown to decrease blood pressure, so some medications containing insulin or diuretics may be less effective. The use of any antidepressant may be associated with a higher risk of diabetes-related complications. Consult your doctor for more information. The risk of developing diabetes with antidepressants varies greatly among people. Your risk may be increased if you are older, have a personal or family history of diabetes, are very overweight, are very obese, or are a woman of childbearing age. Consult your doctor about the possibility of developing diabetes while taking antidepressants. For people with diabetes, the need for monitoring blood glucose levels, eating and exercise regimens, and other lifestyle changes should be addressed with your doctor. It is very important to balance the benefit of the medication against the risk of diabetes-related complications. Do not change your dosage or stop taking your antidepressant without consulting your doctor. Antidepressants that may cause hyperglycemia include:
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Trazodone (Desyrel)
- Venlafaxine (Effexor)
Rapid heart rate
Antidepressants can increase heart rate by as much as 15 beats per minute in adults, even if they have not taken the medication before. The increase in heart rate occurs in the first few hours after taking an antidepressant, and it usually returns to normal on its own within a few weeks. If your heart rate increases to a level greater than 100 beats per minute, discontinue taking the drug. If you have heart problems and have not talked to your doctor about taking an antidepressant, seek immediate medical help.
If you or someone you know is experiencing symptoms such as depression, change in mood, or thoughts of harming or killing oneself, it is important to tell your doctor or health care provider about them. If the signs or symptoms of depression get worse and are interfering with daily life or relationships, or if other changes in mood or behavior are present, you should be seen by a doctor. Suicide is a risk with all types of depression, and early treatment of depression can improve the outcome. It is important that you discuss your symptoms with your doctor.
Anxiety, agitation, confusion, agitation, restlessness, irritability, aggression, akathisia, suicidal thoughts or behavior (even if unsuccessful), and other unusual changes in mood or behavior must be reported immediately. These may be signs of worsening depression or a sign that a patient is at risk for suicide.
Nausea usually begins after starting an antidepressant. These may go away after your body adjusts to the medicine. Consider the following strategies:
- Take an antidepressant with food, unless otherwise directed.
- Eat smaller meals, more often.
- Sucking on sugar-free hard candy.
- Drink plenty of fluids, such as cool water. Try an antacid or bismuth subsalicylate (Pepto-Bismol).
- Talk to your doctor about changing your dose or taking a slow-release medication.
Increased appetite, weight gain
You may gain weight because of the lack or persistence of action, or because your appetite has improved once the symptoms of depression have subsided. Some antidepressants are more likely to cause weight gain. If this is a side effect of this antidepressant, if you are worried about gaining weight, ask your doctor and also discuss ways to address this issue. Consider these strategies:
- Cut back on sweets and sugary drinks.
- Choose healthy, low-fat foods, such as fruits and vegetables, and avoid saturated and polyunsaturated fats.
- Keep a food diary – keeping track of what you eat can help you control your weight.
- Seek advice from a registered dietitian.
- Get regular physical activity or exercise most days of the week.
- Talk to doctor about changing drugs; find out advantages and disadvantages.
Some antidepressants can cause insomnia, which means you may be tired during the day. Consider these strategies:
- Take an antidepressant during the day when prescribed by your doctor.
- Avoid food and drinks with caffeine, especially at the end of the day.
- Exercise or work out regularly – but end it a few hours before bedtime so it does not interfere with your sleep.
- If insomnia is a constant problem, ask your doctor about taking a sedative before bedtime or ask if taking a reduced-dose sedative antidepressant such as trazodone or mirtazapine (Remeron) before bedtime may help.
Constipation is often related to taking antidepressants because they disrupt the digestive tract and other organ systems. Other antidepressants cause constipation . Consider these strategies:
- Drink a lot of water.
- Eat foods high in fiber, such as fresh fruits and vegetables, bran, and whole grains.
- Exercise regularly.
- Take fiber supplements (Citrucel, Metamucil, etc.).).
- Ask your doctor about stool softening medications if other measures do not help.
Dry mouth is a common complication of many antidepressants. Consider these strategies:
- Drink water often or suck on ice chips.
- Chew sugar-free gum or suck on sugar-free hard candies.
- Avoid smoking, alcohol, and carbonated drinks, as they can make your mouth drier.
- Breathe through your nose, not your mouth.
- Brush twice a day, floss daily, and visit your dentist regularly. Dry mouth can increase the likelihood of tooth decay.
- Talk to your doctor or dentist about over-the-counter or prescription oral medications.
- If dry mouth still bothers you despite all the above measures, ask your doctor about the advantages and disadvantages of lowering your antidepressant dose.
Dizziness is more common with tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) compared to other antidepressants. These medications can cause low blood pressure. Consider these strategies:
- Slowly rise from a sitting position to a standing position.
- Use handrails, canes, or other sturdy objects to help.
- Avoid driving or operating machinery.
- Avoid caffeine, alcohol, and tobacco.
- Drink plenty of fluids.
- Take an antidepressant during pregnancy as prescribed by your doctor.
Agitation, restlessness, nervousness
Anxiety agitation or stress can cause the effects of antidepressants. This may indicate that you cannot relax or sit up, even if you feel like it, Although having more energy can be a fantastic thing. Consider these strategies:
- Exercise regularly, such as running, biking or rowing, or some type of physical activity, such as walking. Talk to your doctor about what exercises or activities are right for you.
- Do deep breathing exercises, muscle relaxation or yoga.
- Consult your doctor about temporarily taking a relaxing or calming medication or switching to an antidepressant that is not too stimulating.
Be aware of spontaneous or bouncing thoughts and energy. If they get worse, see your doctor right away, as it could be a sign of bipolar disorder or another illness.
Depending on your heart condition and the type of antidepressant you require, you may need an electrocardiogram (ECG) before or occasionally during therapy. An EKG can be used to monitor what is called the QT interval to make sure it is not prolonged. A prolonged QT interval is a heart rhythm disorder that can increase the chance of serious irregular heart rhythms (arrhythmias). Antidepressants should not be used if you are taking an MAOI or if you have heart problems. Talk to your doctor about your heart health and other heart medications you are taking.
Antidepressants can cause a loss of libido, problems with orgasm, reduced sensitivity to sexual stimuli, or reduced frequency of orgasm. These effects have not been studied extensively in men or women, but they are seen in up to 10% of people. If you lose your sexual drive or have difficulty reaching orgasm, talk to your doctor or health care provider about this. If you experience orgasm with difficulty or only have short-term, partial sexual response, talk to your doctor about your medication or how you can reduce or stop the drug.
Many antidepressants cause side effects. These may include problems and decreased libido. Some antidepressants can cause difficulty achieving or maintaining an erection (erectile dysfunction). Selective serotonin reuptake inhibitors (SSRIs) are more likely to cause sexual side effects than other antidepressants. Consider these strategies:
- Take medication to be taken once a day and program sexual activity before taking that dose.
- Talk to your doctor about switching to an antidepressant that may have fewer similar effects, such as bupropion (Wellbutrin, SR, Wellbutrin XL, others), or adjust your medication to reduce unwanted side effects.
- Talk to your spouse about your sexual side effects and how they change your desires. Fixing your routine can be helpful. You may need a length of foreplay.
- Talk to your doctor about alternative medications, such as sildenafil (Viagra), that can temporarily relieve sexual side effects or treat erectile dysfunction and some other related risks. Don’t take over-the-counter herbal supplements that are guaranteed to increase sexual appetite and sexual function – they are not regulated by the Food and Drug Administration (FDA), and some may be harmful to your health.
Some studies suggest that changes in enzymes may play a role in the risk and effectiveness of unwanted effects of antidepressants that are specific. So your genes may, at least in part, decide if an antidepressant is right for you and most likely you will get specific side effects. Limited testing to help determine the option is already available in some places, but testing is not regular and is not covered by insurance. Studies have been done to find out which antidepressant may be most effective depending on genetics. Genetic testing is part of – not a substitute for – an opinion and more psychiatric evaluation.
For some antidepressants, there are other potential side effects. Be sure to discuss these with your doctor. Consult your doctor if you are experiencing any side effects.