What Are the Side Effects of Antidepressants?

Medically Reviewed by Jabeen Begum, MD on February 20, 2023
Written by Rachel Reiff Ellis
6 min read

Antidepressants can bring relief from many symptoms of depression. But side effects are often part of the package. Some aren’t fun to deal with. Others you can manage. In rare cases, they can be serious and your doctor may need to switch your medication.

 

Everyone reacts to medicines differently, but some side effects are typical. These include:

You may have many, a few, or none of these. Keep in mind that some of these may go away a few weeks after you start your antidepressant.

Some other side effects from antidepressants aren’t discussed as often. But they’re still important to look out for. They may include:

Lower alcohol tolerance. Try drinking alcohol more slowly and drinking less as you get used to your antidepressant. There may be an extra sedative effect when you combine the two.

Bleeding. Antidepressants, particularly SSRIs, can affect platelet clotting and raise your risk of bleeding. Watch out for new easy bruising or nosebleeds, especially if you have a history of bleeding in your gut.

Lower sodium levels. Sometimes, antidepressants can interfere with your blood sodium level, which can cause headaches or confusion. Low sodium levels, called hyponatremia, are more common in older people. The risk is also a lot higher in the first 2 to 4 weeks after you start an antidepressant.

Watch for symptoms of hyponatremia when you’re adjusting to a new antidepressant. Along with headaches and confusion, these include:

  • Nausea
  • Vomiting
  • Drowsiness
  • Fatigue
  • Crankiness
  • Restlessness
  • Muscle cramps, spasms, or weakness
  • Seizures

Call your doctor if you notice these symptoms.

 

Everyone reacts differently to medication. Your side effects may not be the same as those of someone else who takes the same thing. Some people don’t notice any problems.

Things that may affect how you respond to antidepressants include:

  • Other medications. Some drugs might interact. This can lead to more side effects if your other medications are increasing the level of your antidepressant. On the other hand, other medications may cause your antidepressant to be less effective. This is why it’s important to make sure that all your health care providers have a complete list of the medications you’re taking, both prescription and over-the-counter.
  • Age. Older people are more likely to have some kind of a side effect.
  • Genes. Your genes affect the way your body handles drugs. For example, if your body absorbs medication slowly, you may be more prone to side effects.
  • The type of drug. Older medications like tricyclic antidepressants and MAOIs tend to have more side effects than SSRIs, SNRIs, and atypical antidepressants.

Some general things can help you ease side effects when taking your antidepressants:

  • Eat small, more frequent meals throughout the day to help your digestion.
  • Drink plenty of water.
  • Cut back on sweets and saturated fats
  • Eat plenty of veggies and fruits.
  • Keep a food diary so you can see if something you’re eating is ramping up your side effects.
  • Practice relaxation methods, like deep breathing or yoga.
  • Get regular exercise.

Depending on which side effects you have, there are specific things that can help:

Nausea: Suck on sugarless candy, and ask about a slow-release version of your antidepressant. Take the medication at night so the nausea doesn’t bother you as much.

Sexual issues: Have sex right before you take your antidepressant, when effects are lowest. Talk to your doctor about other things that can help, like estrogen cream or erectile dysfunction medication.

Fatigue: Take your meds at night before bed. Try to have a short nap during the day, too.

Trouble sleeping: Take your antidepressant in the morning instead of close to bedtime, stay away from caffeine, and ask your doctor about any medicines that can help you sleep.

Dry mouth: Carry water with you throughout the day, suck on ice chips, or chew gum. Try to breathe through your nose instead of your mouth. Talk to your doctor about medication that can help you make more saliva.

Blurred vision: Ask your doctor about special eyedrops that can moisten your eyes.

Constipation: Eat plenty of high-fiber foods, or take a fiber supplement. Stool softeners can help, too.

Dizziness: Move slowly, especially when standing up. Take your antidepressant at bedtime.

These may include: 

Disliking medication. Some people hate having to take medicine to feel better. This can lead to not taking it the way you’re supposed to, or quitting altogether. Talk to your doctor about the risks, benefits, and alternatives of medication and how it fits into your lifestyle, he suggests – especially because medication isn’t the only recommended treatment for depression.

Emotional blunting. You may notice that you feel emotionally numb when you take an antidepressant. Unfortunately, this is a common side effect. To manage it, you might try:

  • Talking to a therapist about ways to boost your mood
  • Asking your doctor about lowering your antidepressant dose
  • Taking part in activities that boost serotonin, like exercise, massage therapy, and light therapy
  • Relying on medication alone. Lots of people use antidepressants as their only treatment for depression. But when you’re depressed, there may be something you need to talk about or work on in psychotherapy. This is why it’s an important part of depression treatment.

 

Some side effects are serious. If you have any of these symptoms, tell your doctor right away:

  • Thoughts about or attempts at suicide
  • More feelings of depression and anxiety
  • Feeling very agitated or restless
  • Panic attacks
  • Trouble sleeping
  • New or worsening crankiness
  • Aggression or violence
  • Hallucinations
  • Acting out dangerous impulses
  • Feeling hyperactive
  • Other unusual changes in behavior or mood

Sometimes, antidepressants can mix with other medicines and pose life-threatening problems. Pay close attention to any new symptoms or ones that get worse.

If the side effects of your current antidepressant are too much, talk to your doctor about a change. It’s important not to stop taking your antidepressant without talking to your doctor first. Quitting cold turkey can cause withdrawal symptoms or make your depression worse.

When you switch, your doctor will decide which method will be best to avoid withdrawal. Your doctor will watch you closely while you go through this process.

There are many ways to change your medicine, including:

Conservative switch:

  • You'll gradually lower your dose of your current antidepressant until you stop.
  • You won't take any medication for a specific number of days.
  • After that, you'll start your new medicine at the recommended dose.

Moderate switch:

  • You'll gradually lower your dose of your current antidepressant until you stop.
  • You won't take any medication for a specific number of days.
  • Next, you'll start the new medication at a low dose and raise it gradually.

Direct switch:

  • You'll stop your current antidepressant.
  • The next day, you'll start the new antidepressant at full dose.

Cross-taper:

  • You'll gradually lower the dose of your current antidepressant until you stop.
  • As your old antidepressant dose goes down, you'll start taking the new antidepressant at a low dose.
  • You'll take more of the new antidepressant as you take less of the old antidepressant until you’ve stopped the first and are at a full dose for the second.

Only your doctor can decide which of these methods is right for you.

Quitting your antidepressant cold turkey can be physically uncomfortable, especially if you’ve been on it for a while. And if you’ve been taking a higher dose, you can get something called discontinuation syndrome. As the medication leaves your body, you start feeling headache or flu-like symptoms.

Stopping your medication means you also risk the return of your depression symptoms. You may feel better now that you’re taking it, but this doesn’t mean you don’t need it anymore. You’ll need to keep taking your antidepressant to prevent a relapse.

If the side effects are too much, talk with your doctor. Keep in mind that the first medicine you try may not be the right one for you. It might take some trial and error to find which antidepressant and dose work best.

You may get to a point where you want to stop your medication. Talk to your doctor first. That way, you can discuss other treatment options and agree on a schedule to taper off over time to keep discomfort to a minimum.