Depression Health Center

How Long Should You Take Antidepressants?

If you are considering taking an antidepressant, you may be concerned about how long you’ll need to stay on it. Even if you feel that it will help treat your depression, you may not like taking any medicine if you can help it. You may wonder about side effects or long-term effects of taking a drug that alters brain chemistry.  

If you’re already taking a medication for depression, you might be wondering about when to stop. If your mood and outlook on life have gotten brighter, do you really need to continue taking an antidepressant?

In general, doctors recommend that people stay on an antidepressant at least one year to experience the full benefits. Beyond that, when -- and whether -- you should to go off depression medication is a personal choice that requires serious thought. This article will help you understand different types of medications that treat depression, how the use them most effectively, and what to consider when deciding how long to take them.

How Depression Medications Help Mend the Mind

“Often a patient with depression will come in, very reluctant to try medication,” says Anthony Rothschild, MD, professor of psychiatry and director of the Center for Psychopharmacologic Research and Treatment at the University of Massachusetts Medical School in Worcester. “Then once they decide to try it, they thank me for convincing them to take it.”

Antidepressants work by targeting certain chemicals in the brain called neurotransmitters. These chemicals affect mood and emotion. But exactly how antidepressants lessen depression is unclear.

Experts have traditionally thought that they restore a chemical imbalance caused by being depressed. But some researchers now believe that depression and stress may actually destroy the connections between nerve cells -- and even the cells themselves. They believe that antidepressants work by restoring these nerve pathways.

Types of Antidepressants and Their Side Effects

There are five types of antidepressant medications available. Most target neurotransmitters such as serotonin, norepinephrine, and dopamine.

All of these medicines can cause side effects. About half of the people who take them experience side effects, especially during the first few weeks of treatment.

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressant medication. They tend to be well tolerated and effective. 

Serotonin and norepinephrine reuptake inhibitors (SNRIs) are a newer class of antidepressants and are similar to SSRIs. They are also commonly prescribed to treat depression.

Possible side effects for both SSRIs and SNRIs include:

• Nausea
• Sleep difficulties
• Diarrhea
• Agitation (feeling jittery)
• Rash
• Sexual problems 

Norepinephrine and dopamine reuptake inhibitors (bupropion) have no sexual side effects, unlike many other antidepressants. Possible side effects of these popular medicines are:

• Agitation
• Headache
• Loss of appetite
• Insomnia

Tricyclics are an older class of depression medications that are prescribed less often because of more serious side effects. For example, people with heart disease, congestive heart failure, and arrhythmia should avoid them. Generally, they are only prescribed for people who not respond to treatment with newer antidepressants. Possible side effects include:

• Dry mouth
• Constipation
• Weight gain or loss
• Bladder problems
• Sexual problems
• Blurred vision
• Drowsiness

Monamine oxidase inhibitors (MAOIs) are also older antidepressants that are usually only prescribed for people who do not respond to other drugs for depression. They may also benefit people who have unusual symptoms such as excessive sleeping, hypochondria, or high levels of anxiety. People who take MAOIs must restrict their diet in order to avoid serious complications. They should avoid pickled, smoked, or fermented foods as well as certain beverages and medications. Possible side effects include:

• Constipation
• Drowsiness
• Sleep problems
• Weight gain
• Headache
• Upset stomach
• Dizziness
• Weakness
• Trembling, twitching, or unusual muscle movements
• Sexual problems