Managing the side effects of antidepressants

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Depression: Dealing With Medicine Side Effects

Side effects are a common problem for people who take antidepressants. If you are bothered by side effects, reading this information can help you learn more about how to cope with them.

Key points

Most side effects are temporary and will go away after you take the medicine for a few weeks.
Some side effects may not go away, but usually there are ways you can learn to manage these problems.
If the side effects bother you, your doctor may be able to lower your dose or change your medicine.
Do not suddenly quit taking your medicine. That could cause withdrawal symptoms or a return of your depression.
Be aware of possible serious side effects of antidepressants, such as chest pain or a serious allergic reaction, and call your doctor right away if you notice any.

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What side effects can antidepressants cause?

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What side effects can antidepressants cause?

Side effects may vary depending on the medicine you take, but common ones include:

Nausea.
Dry mouth.
Loss of appetite.
Diarrhea or constipation.
Sexual problems (loss of desire, erection problems).
Headaches.
Trouble falling asleep, or waking a lot during the night.
Feeling nervous or on edge.
Feeling drowsy in the daytime.

Most side effects are temporary and will go away after you take the medicine for a few weeks. But some (such as dry mouth, constipation, and sexual problems) may continue. If you have questions or concerns about your medicines, talk to your doctor.

Different medicines may cause different side effects. Learn more about the side effects of:

Selective serotonin reuptake inhibitors (SSRIs), such as Paxil, Prozac, and Zoloft.
Tricyclic and tetracyclic antidepressants, such as amitriptyline, maprotiline, and Pamelor.
Other antidepressants, such as Effexor, Remeron, and Wellbutrin.
Monoamine oxidase inhibitors (MAOIs), such as Marplan, Nardil, and Parnate.

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Some side effects will last the whole time you are taking antidepressants.

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Why should you keep taking an antidepressant if it causes side effects?

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Why should you keep taking an antidepressant if it causes side effects?

Most antidepressants cause minor side effects that go away or improve in the first few weeks of treatment. If you keep taking your medicine, there is a good chance that you will start to feel less depressed and the side effects will decrease. Most people feel that the benefits of antidepressants are well worth the price of living with some side effects.

If the side effects continue to bother you, talk to your doctor. You might be able to try a different dosage or a different medicine.

Even if you are going to change medicines, you should not suddenly quit taking your current antidepressant. That could cause withdrawal symptoms or make your depression come back. Work with your doctor to make the switch safely. This may require slowly reducing the dose of the old medicine before you start the new medicine.

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If the side effects bother you, you should just quit taking your medicine.

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How to manage the side effects of antidepressants

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How to manage the side effects of antidepressants

Try these tips to help you manage some of the common side effects of antidepressants.

Constipation	Eat bran and other whole-grain cereals and high-fiber fruits and vegetables, such as apples, prunes, beans, and broccoli. Drink plenty of fluids.
Daytime drowsiness	This problem usually goes away as your body adjusts to the medicine. Ask your doctor if you can take your medicine at bedtime. Do not drive or operate heavy equipment when you feel drowsy.
Diarrhea	Eat mild, low-fiber foods, such as applesauce, rice, and yogurt. Avoid spicy and high-fat foods until you feel better.
Dizziness	Get up slowly from sitting or lying down.
Dry mouth	Chew sugarless gum or suck on sugarless candy. Take frequent sips of water throughout the day.
Headaches	These usually will go away as your body adjusts to the medicine. Ask your doctor what medicine you can take for a headache.
Loss of appetite	Try to eat more often. Have healthy snacks between meals. Include favorite foods at each meal. Take a walk before you eat. This may make you more hungry.
Nausea	Eat several smaller meals a day rather than two or three large meals. Try peppermint candy or gum. Peppermint can help settle your stomach.
Feeling nervous or on edge	This will probably go away soon. If it lasts, ask your doctor if you can reduce your dose.
Sexual problems	Ask your doctor if you can take a lower dose. Ask your doctor if there is another medicine you can try.
Sleep problems	Avoid caffeine, nicotine, and alcohol. Don't exercise in the late afternoon or evening. Keep your bedroom quiet, dark, and cool, and use a sleep mask and earplugs. If these problems don't go away over time, ask your doctor about reducing your dose. Change the time of day you take your medicine to the morning.

Watch for serious side effects

Serious side effects don't happen often, but you should be aware of them. Call your doctor right away if you or anyone who takes antidepressants has:

Chest pain.
Hives, shortness of breath, trouble swallowing, swollen lips, or other signs of a serious allergic reaction.
Warning signs of suicide, such as talking or writing about death, giving away belongings, or withdrawing from family and friends.
Manic behavior, such as having very high energy, sleeping less than normal, being impulsive, or being grouchy or restless.

Cautions

Be sure your doctor knows about any other health problems you have and whether you are allergic to any drugs. This can affect what medicine your doctor prescribes for you.
Tell your doctor about any medicines you take regularly, including over-the-counter drugs, vitamins, and herbs. This can help you avoid harmful drug interactions.
Do not take any other medicines without talking to your doctor first. Even common medicines such as aspirin and some vitamins and herbs can cause problems if you use them while you are taking antidepressants.
Do not drink alcohol or use illegal drugs. They can make side effects worse.

Test Your Knowledge

You need to be very careful about using other medicines when you are taking antidepressants.

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Other Works Consulted

National Institute of Mental Health (2005, addendum 2007). Medications for Mental Illness (NIH Publication No. 02-3929). Bethesda, MD: National Institute of Mental Health. Available online: http://www.nimh.nih.gov/health/publications/medications/summary.shtml.

By	Healthwise Staff
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Lisa S. Weinstock, MD - Psychiatry
Last Revised	January 12, 2011

WebMD Medical Reference from Healthwise

Last Updated: January 12, 2011

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.