It’s important to know what to expect when starting on an antidepressant and to be aware of common side effects of antidepressants. Most commonly, antidepressant side effects happen when a medication is started. With antidepressants side effects are usually manageable and time-limited.
I find when people are aware of potential side effects and how long they may last, they are more tolerant of transitional discomfort while their body gets used to the medicine. If people aren’t aware of the common side effects of antidepressants they may stop the medication assuming they don’t tolerate it.
In this post, I am referring to the common side effects possible on “newer” antidepressants such as Selective Serotonergic Reuptake Inhibitors (SSRI), Serotonin and Norepinephrine Reuptake Inhibitors (SNRI), and Atypical antidepressants. I am not referring to side effects from the “older” classes of antidepressants like Tricyclics (TCA’s) or Monoamine Oxidase Inhibitors (MAOi’s). The side effect profiles of TCA’s and MAOi’s are different than with SSRI/SNRI/Atypical antidepressants and therefore I am going to stick to covering the medications most commonly prescribed at this time.
If you would like to read more about different medication classes check out this article that has a great summary.
Antidepressant side effects are similar between SSRI, SNRI, and Atypical classes
In general, side effects are similar between the newer antidepressants. There are a few side effect variations between the different medications. These side effect differences can help us choose which antidepressant to start when we don’t have other specific reasons to choose one.
Variations in antidepressant side effects:
Some antidepressants have a higher chance of weight gain, withdrawal symptoms (ie discontinuation syndrome), sleep disruptions (interfering with sleep or causing sedation), or sexual side effects.
The most common side effects of antidepressants:
The most common initial side effects of antidepressants are headache, stomach upset, and jitteriness. These side effects will fade and shouldn’t be severe.
Sexual side effects happen in up to 40% of people on most of the “newer” antidepressants. The sexual side effects do not happen on Wellbutrin. In general, sexual side effects will last for the duration of time on the medication. The sexual side effects vary in severity and can be minor or completely impairing (ie inability to have an orgasm or get/maintain an erection). Sometimes, if a dose is lowered the sexual side effects will lessen however the medicine may also be less effective.
Initial side effects are generally brief (up to 2 weeks). They should feel like more of a nuisance than anything severe. If it’s severe, there may be a significant intolerance to the medication (or misdiagnosis). Most people don’t get any side effects if the dosing is increased gradually.
Start lower and raise slower with anxiety:
When people are being started on an antidepressant for the treatment of an anxiety disorder, I generally start the antidepressant at lower than recommended doses. Once it is tolerated, I then raise the dose slowly in small increments. Jitteriness is one of the common initial side effects and this can be extra unpleasant for someone that is already anxious.
If you have stomach upset from the antidepressant take it with food and don’t let yourself get hungry. Your stomach needs to adjust to the medicine and it should go away soon. If your stomach starts to feel queasy just eat again. Frequent smaller meals can help when you are starting an antidepressant. Unlike the queasiness from a GI bug, having food in your stomach will help you feel better.
If the antidepressant doesn’t bother your stomach than you don’t have to take it with food.
When to take the antidepressant?
Many antidepressants can be taken either in the morning or at night. Some antidepressants are more energizing or activating than others (ie Welbutrin and Prozac) so I recommend starting these in the morning. Paxil and Zoloft may have a bit more chance to cause sedation so start these at night. If the medicine doesn’t affect your alertness then take it whenever you are most likely to consistently remember it.
Sometimes the activating or sedating side effects are temporary. Once your body adjusts to the medication switch to whenever is best for you to consistently take it.
Struggling with antidepressant side effects? Try liquid medication
If you are getting uncomfortable initial side effects you may benefit from trying an antidepressant that comes in a liquid form. These can be dosed in tiny amounts that are gradually increased as your body adjusts to the dose.
Beware! The liquid antidepressants usually taste awful. As soon as you are able to raise the dose enough you can switch back to the pill form.
Antidepressant Side Effects
I cover antidepressants side effects with my patients when they are starting an antidepressant medication. I find side effects are better tolerated when people are aware of what to expect. If you are interested in reading more details about antidepressant side effects check out this article from Harvard that goes into more details.
This is not a complete list of all possible side effects. There are all sorts of random side effects that could happen that are either uncommon or an unpredictable response in an individual. Make sure to contact your psychiatrist if you have started on an antidepressant and have a question about a side effect.
More Resources and Tools for Treatment:
Antidepressants are one treatment for depression and anxiety. I have written other posts to help give people additional tools to overcome their symptoms faster.
Here are some of my most popular posts on depression and anxiety:
- 11 Effective Interventions for Depression
- Treating Depression With Exercise (this is a 3 part series)
- 30 Healing Mantras for Depression
- 5 Ways to Stop a Panic Attack
- The Best Resources for Anxiety
- Do what you are afraid of: Stop letting anxiety control you
Visit my mental health bookstore for a list of books I recommend for anxiety and depression (and many other mental health topics).