Antidepressant Side Effects and How to Manage Them

Antidepressant side effects are experienced by almost everyone who takes the medication, at least initially.

Antidepressants are medications that have been used since the 1950s to treat depression and other disorders. These medications alter chemicals in the brain like serotonin, dopamine and norepinephrine.

Often the side effects of antidepressants fade over days or weeks as the body adjusts. Some side effects of depression medication, though, can be ongoing and may require stopping or switching antidepressant medication. No antidepressant should ever be stopped without first talking to the prescribing doctor.

First Generation Antidepressant Side Effects

Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) were the first types of antidepressants developed. These medications affect many systems in the body and are more prone to side effects. Side effects of these antidepressants can also be more severe than those seen in newer SSRI or SNRI antidepressants.

All antidepressant side effects should be reported to the prescribing doctor to ensure the symptoms are not indicators of something more serious.

Common first-generation antidepressants side effects include:¹

• Dry mouth – can be treated by chewing gum, sipping water, sucking candy or with over-the-counter dry mouth medications.
• Fatigue, sedation – may be treatable by altering the antidepressant dose or time medication is taken; also by taking a nap or getting more exercise.
• Insomnia – may be treated by improving sleep hygiene, changing when the antidepressant is taken, exercising, or over-the-counter or prescription sleep aids.
• Headache – over-the-counter non-steroidal anti-inflammatory medications (NSAIDS) like ibuprofen (Motrin) may help.
• Nausea – may be helped by taking the medication with food, eating smaller, more frequent meals and drinking plenty of water; over-the-counter nausea medication is also available.
• Dizziness or light-headedness, especially when arising from a sitting or lying position – rising slowly can help; from the bed, try laying on your side, then sitting up, dangling legs before standing; avoid caffeine, tobacco, and alcohol.
• Weight gain – focus on a healthy lifestyle including diet and exercise may help; you can also consult a dietician.
• Sensitivity to sunlight / heat –by staying out of the sun and wearing sunscreen, full sleeves, long pants, and a hat while outside you can avoid feeling ill or getting a rash.
• Constipation – eating high-fiber foods, drinking more water, getting exercise or taking a fiber supplement can help.

Other side effects of depression medication that may need professional help include:

• Tremor
• Unpleasant taste
• Diarrhea
• Weakness
• Anxiety, nervousness, unusual excitement
• Excessive sweating
• Pounding heart
• Swelling of feet and/or lower legs
• Dark urine
• Fever
• Skin rash

Side Effects of Modern Antidepressants

More commonly, people are now prescribed selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs) or similar antidepressants. These medications are generally considered much safer than TCAs or MAOIs. SSRI and SNRI antidepressants tend to have fewer side effects and are much less likely to cause a fatal overdose.

Modern antidepressant side effects include some of those seen in first-generation drugs. Side effects of newer antidepressants also include:

• Anxiety – may be improved through therapy like cognitive behavioral therapy, exercise, relaxation techniques or treated with medication.
• Sexual dysfunction – may be treated with additional medication or by changing medications.
• Menstrual changes – may require changing antidepressants.
• Blurred vision – may be helped with eye drops.
• Serotonin Syndrome - requires lowering serotonin medication dosage.

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