Antidepressant Side Effects

Antidepressant Side Effects

Depression: What to Do with Those Antidepressant Side Effects

Maria’s depression was difficult to treat. As you can recall, various medications had been tried to no avail. But after several months of treatment, Maria has eventually become stable on a combination of two antidepressants.

She’s now able to do her usual activities and is motivated to go back to work — something she has struggled to do for a while. Despite her improvement, antidepressant side effects have emerged and are bothersome. Maria begins to consider discontinuing her medications prematurely.

Antidepressant side effects are real and negatively affect patient’s compliance. Many patients like Maria consider stopping the medication even at the risk of relapse because of distressing side effects.

How do you deal with some of the common antidepressant side effects?

Insomnia

Some antidepressants e.g. SSRIs (serotonin-reuptake inhibitor) are highly stimulating that they cause insomnia when taken in the afternoon or at bedtime. Take this type of medication in the morning. Discuss with your physician the use of a sedating medication such as trazodone or sedative-hypnotic drug along with the antidepressant.

If you want to take only one pill, talk to your doctor about switching to a sedating antidepressant such as mirtazapine. Moreover, sleep hygiene should be practiced. Avoid naps and intake of caffeinated drinks such as coffee and soda in the afternoon and evening. Involve in regular exercise and physical activities during the day. Moreover, use the bedroom only for sleep and sex and not for recreational activities.

Weight gain

Regular exercise is weight gain’s antidote. If no medical contraindication, you may consider jogging, walking, or swimming. To reduce some excess and unwanted fat, keep yourself busy with physical and recreational activities.

How about diet? Diet has always been a part of any weight control regimen. Monitor your carbohydrate intake. Ice cream, chocolates, and other high-caloric foods should be reduced. If none of the above works, talk to your doctor about switching pills.

Sexual dysfunction

Sexual dysfunction happens too often but is rarely asked or discussed in the clinic. Some physicians and patients feel embarrassed about this subject. When you have concerns, be open to your physician. Discuss the possibility of switching medication to an antidepressant (such as bupropion or mirtazapine) that doesn’t significantly impair sexual functioning.

Also, talk to your doctor about adding another drug such as bupropion, yohimbine, or even mirtazapine to counteract the sexual side effect. How do you know if the sexual dysfunction is from the pill rather than from depression? If the dysfunction persists despite successful remission of depression, then you should consider other causes such as drug-induced dysfunction or other medical causes e.g. diabetes.

Dry mouth

Tricyclic antidepressants (TCA e.g. amitriptyline) are notorious for causing dry mouth. Why? These drugs have distressing anticholinergic side effects. Avoid this type of drugs. If TCA is still considered, talk about the use of desipramine or nortriptyline.

Compared to other TCAs, these two drugs have less anticholinergic effects. Moreover, try ice chips. Frequent sips of water should also help. To avoid dental cavities, try sugarless candy or sugar-free gum.

Constipation

Like dry mouth, constipation is usually caused by TCAs. To prevent it from happening, drink enough water and eat high fiber foods such as vegetables and fruits. Consider stool softeners if the above interventions fail. If possible, avoid TCAs.

Nausea and vomiting

Patience is the key in dealing with these side effects. Frequently, patients develop tolerance within two weeks. Take the medication with food. If ineffective, talk to your doctor about possibly reducing the dose of your medication or trying antacid or bismuth salicylate (Pepto-Bismol)

Memory lapses

If given permission by your doctor, try to reduce the dose. Also, discuss with your physician about switching antidepressant (especially if dose reduction doesn’t alleviate your concern) and avoiding drugs with anticholinergic side effects.

Moreover, don’t mix the antidepressant with alcohol. The alcohol-drug interaction can only worsen the memory and cognitive functioning. While on psychotropic drugs, be careful driving and using mechanized equipment.

Dizziness

While still in bed, sit up for 30 seconds, then stand up for another 30 seconds while holding a rail, a table, or a chair before walking. Take the medication at bedtime. Some people use support hose with success.

Agitation or anxiety

Some people benefit from a brief use of benzodiazepine such as lorazepam. Breathing exercises and progressive muscle relaxation should also help. In general, some side effects such as gastrointestinal upset and insomnia may resolve in a few days. Patience is the key. However, be on guard. When they occur, address them promptly. I’m not however suggesting that you should be your own doctor.

Collaborating with your doctor is an effective way to cope with mental illness and medication problems. Treatment options such as the need to switch or reduce medications should be discussed in an open and accepting manner.

Copyright © 2003. All rights reserved. Dr. Michael G. Rayel – author (First Aid to Mental Illness–Finalist, Reader’s Preference Choice Award 2002), speaker, workshop leader, and psychiatrist. Dr. Rayel pioneers the CARE Approach as a first aid for mental health. To receive free newsletter, visit www.drrayel.com. His books are available at major online bookstores.

FAQ 

What are common side effects of antidepressants?

** SSRIs and SNRIs

* feeling agitated, shaky or anxious.

* feeling and being sick.

* indigestion and stomach aches.

* diarrhoea or constipation.

* loss of appetite.

* dizziness.

* not sleeping well (insomnia), or feeling very sleepy.

* headaches.

Do antidepressants actually make you happy?

Antidepressants help relieve the symptoms of depression and associated anxiety. They do not make you euphoric, but simply help you react more realistically in your emotional responses. You may notice, for example, that you take in your stride little things that used to worry you or get you down.

Are antidepressants bad for you?

Antidepressants can cause dizziness and unsteadiness, increasing the risk of falls and bone fractures, especially in older people. Interactions with other medications can increase this risk. A very small number of people have had heart problems, epileptic fits or liver damage while taking antidepressants.

What  is the most energizing antidepressant?

Prozac (fluoxetine) and Wellbutrin (bupropion) are examples of “energizing” antidepressants; whereas Paxil (paroxetine) and Celexa (citalopram) tend to be more sedating.

Which antidepressant is best for anxiety?

The antidepressants most widely prescribed for anxiety are SSRIs such as Prozac, Zoloft, Paxil, Lexapro, and Celexa. SSRIs have been used to treat generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder, and post-traumatic stress disorder.

Do antidepressants change your personality?

Fact: When taken correctly, antidepressants will not change your personality. They will help you feel like yourself again and return to your previous level of functioning.

What is the best antidepressant to lose weight?

In conclusion, we find that bupropion is the only antidepressant associated with long-term weight loss (although this effect is limited to nonsmokers).”

How do I stop antidepressant fatigue?

* Fatigue, drowsiness

* Take a brief nap during the day.

* Get some physical activity, such as walking.

* Avoid driving or operating dangerous machinery until the fatigue passes.

* Take your antidepressant at bedtime if your doctor approves.

* Talk to your doctor to see if adjusting your dose will help.

Sertraline side effects

Sertraline may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

* nausea.

* diarrhea.

* constipation.

* vomiting.

* difficulty falling asleep or staying asleep.

* dry mouth.

* heartburn.

* loss of appetite.

** Zoloft side effects

What Are Side Effects of Zoloft?

* sleepiness.

* drowsiness.

* tired feeling.

* nervousness.

* sleep problems (insomnia)

* dizziness.

* nausea.

* skin rash.

** Lexapro side effects

Common Lexapro side effects may include:

* painful urination;

* dizziness, drowsiness, tiredness, weakness;

* feeling anxious or agitated;

* increased muscle movements, feeling shaky;

* sleep problems (insomnia);

* sweating, dry mouth, increased thirst, loss of appetite;

* nausea, constipation;

* yawning;

** Trazodone side effects

Trazodone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

* headache.

* nausea.

* vomiting.

* bad taste in mouth.

* diarrhea.

* constipation.

* changes in appetite or weight.

* weakness or tiredness.

What actually causes depression?

Research suggests that depression doesn’t spring from simply having too much or too little of certain brain chemicals. Rather, there are many possible causes of depression, including faulty mood regulation by the brain, genetic vulnerability, stressful life events, medications, and medical problems.

What do you do when antidepressants don’t work for you?

If your depression symptoms return for more than a few days, it’s time to see your doctor. But even if you feel like your antidepressant isn’t working, it’s important to keep taking it until your doctor advises otherwise. You may need a dosage increase or a slow tapering off process.

What is it called when antidepressants stop working?

But because they treat the symptoms of depression, and not the underlying cause, the effectiveness of these medications may not be lasting. For many people with depression, medicines that have helped may, at some point, seem to stop working. This loss of effectiveness is called tachyphylaxis.

Which of the following is seen as an effective treatment for severe depression that does not respond to drug therapy?

Electroconvulsive therapy (ECT) is a medical treatment most commonly used in patients with severe major depression or bipolar disorder that has not responded to other treatments.

How do you know when antidepressants stop working?

Signs that your antidepressant might not be working include: You feel more or the same amount of sadness, anxiety, or irritability after several weeks or months of taking the medication. You feel slightly better, but still feel that your depression is affecting your ability to function. You are having trouble sleeping.

Can you still have bad days on antidepressants?

What if I continue having good and bad days? You may be having a partial response to the drug. If you have residual symptoms, your depression is more likely to return. Many people feel so much better with medication that they dismiss such symptoms as just having a “little” trouble sleeping or a “slight” energy problem.

Is three  hope for treatment-resistant depression?

For treatment-resistant depression, there is always hope. As difficult as it may seem to deal with the symptoms of treatment-resistant depression, there are many different ways to approach it and, with patience and support, you will achieve relief.

What is the strongest antidepressant medication?

The most effective antidepressant compared to placebo was the tricyclic antidepressant amitriptyline, which increased the chances of treatment response more than two-fold (odds ratio [OR] 2.13, 95% credible interval [CrI] 1.89 to 2.41).

Can antidepressants make you lose motivation?

Selective serotonin reuptake inhibitors (SSRIs), commonly used to treat depression, are associated with loss of motivation, anergy, and lack of curiosity often referred collectively as apathy.

Do you feel worse after starting antidepressants?

When you start an antidepressant medicine, you may feel worse before you feel better. This is because the side effects often happen before your symptoms improve. Remember: Over time, many of the side effects of the medicine go down and the benefits increase.

Can I take my antidepressant an hour late?

Generally you can take a skipped day, but before doing so consult with your doctor or pharmacist.” If it has been less than two hours since your scheduled dose, it is okay to go ahead and take your missed dose.