Everything You Need To Know About Antidepressants

I have gathered the most insightful information on antidepressants and put them all in one blog post. The information came from various popular medical websites, such as Centre for Addiction and Mental Health, National Health Service (NHS), Mayo Clinic, and WebMD. My hope is that you find this easy to read and understand. 

What Are Antidepressants?

“Antidepressant medications are most commonly used to help relieve the distress of depression or anxiety. They are also used to help with other conditions, such as bulimia and chronic pain.”[1]

What Conditions Are Antidepressants for?

Antidepressants can be used to help with:

  • Depression
  • Anxiety
  • Obsessive-compulsive disorder
  • Panic disorder
  • Serious phobias
  • Bulimia
  • Post-traumatic stress disorder
  • And some pain disorders, which include complex regional pain syndrome, peripheral neuropathy, multiple sclerosis, fibromyalgia.[2]

Do Antidepressants Work?

Research suggests about 70 per cent of people who try antidepressants get some relief from them. They work best when they are combined with counselling, support from loved ones, and self-care.

Be patient. Once you start an antidepressant, it may take six or more weeks for it to be fully effective. If one doesn’t work, try something else. Talk to your doctor if you don’t think it’s working. He/she might suggest changing the dose, trying a different antidepressant, or adding a second antidepressant or another medication.[3]

How Do Antidepressants Work?

“Antidepressant medications increase the activity of certain chemicals, known as neurotransmitters, in the brain. Increasing the activity of the neurotransmitters serotonin, norepinephrine and dopamine seems to help lessen depression and anxiety.”[4]

Side effects of Antidepressants

Not everyone has the same side effects. Some might have none. Most of the time, the side effects fade within a few weeks. In some cases, they may last the whole time on the medication. Common side effects include:

  • Nausea
  • Increased appetite and weight gain
  • Loss of sexual desire and other sexual problems
  • Fatigue and drowsiness
  • Insomnia
  • Dry mouth
  • Blurred vision
  • Constipation
  • Dizziness
  • Agitation
  • Irritability
  • Anxiety[5]

If side effects become too hard to deal with, you should talk to your doctor.

Your doctor may:

  • “Encourage you to wait a little longer for the side effects to fade
  • Adjust your dose
  • [Suggest] you take the medication at a different time of day
  • Prescribe other medications to help control side effects
  • Change your medication
  • Stop medication treatment and suggest a different type of treatment approach”[6]

It’s best to wait and see if the side effects improve because symptoms usually go away as your body adjusts to the antidepressant.

Antidepressants and Risk of Suicide

In some cases, people under the age of 25 may have an increase in suicidal thoughts or behavior when taking antidepressants. This tends to happen in the first few weeks after starting or when the dose is changed.[7] This could be due to some of the symptoms, such as agitation, restlessness and detachment which may lead to feelings of hopelessness and despair.[8] However, in the long run antidepressants are more likely to reduce suicide risk by improving mood and behaviour.

When you start taking antidepressants, monitor your thoughts and moods. Tell your doctor, a crisis line or the emergency department if you have any thoughts of harming yourself or others.

Antidepressants and Weight Gain

Some people do gain weight while taking antidepressants, but the antidepressant isn’t necessarily the cause.  “For instance, the added medication could improve a person’s appetite … and that causes them to gain weight.  Some people may even lose weight, due to a drop off in emotional eating once they start taking the medication.”[9]

Antidepressants and Pregnancy

“A decision to use antidepressants during pregnancy is based on the balance between risks and benefits. Overall, the risk of birth defects and other problems for babies of mothers who take antidepressants during pregnancy is very low. Still, few medications have been proved safe without question during pregnancy, and some types of antidepressants have been associated with health problems in babies.”[10]

Certain selective serotonin reuptake inhibitors (SSRIs) Okay
Serotonin and norepinephrine reuptake inhibitors (SNRIs) Okay
Bupropion (Wellbutrin) Okay
Tricyclic Okay
The SSRI paroxetine (Paxil) Generally discouraged as it may be associated with a small increase in fetal heart defects
monoamine oxidase inhibitors (MAOIs), phenelzine, tranylcypromine Generally discouraged as it might limit fetal growth
Citalopram, fluoxetine and sertraline Generally discouraged as some research suggests these may (but rarely) cause a serious newborn lung problem when taken during the last half of pregnancy

If you take antidepressants throughout pregnancy or during the last trimester, your baby might experience withdrawal symptoms. However, tapering the dose near the end of pregnancy isn’t thought to minimize newborn withdrawal symptoms.[11]

Are Antidepressants Addictive?

Addictive drugs produce a feeling of euphoria and a strong need to continue using the drug. Antidepressants does not produce those feelings.

“Antidepressants do, however, have one thing in common with some addictive drugs—they can cause withdrawal effects when you stop taking them. When you take antidepressants for months or years, your body adjusts to the presence of the drug. If you then stop using it, especially if you stop suddenly, you may experience withdrawal effects such as muscle aches, electricshocklike sensations, dizziness, headache, nausea, chills and diarrhea … Some people find these effects distressing and have difficulty withdrawing from these drugs.”[12]

Drinking Alcohol While on Antidepressants

Drinking alcohol while on antidepressants isn’t dangerous in itself. But, it can worsen your depression or anxiety. Alcohol make some side effects of the antidepressants worse, making you more sleepy, dizzy and lightheaded. Because of this, one drink could have the effect of two or three drinks. “However, if you have been taking antidepressants for more than a few weeks, and you are feeling well, having a drink or two on occasion should be okay.”[13]

Combining Antidepressants With Other Medications

Antidepressants can react unpredictably with other medications, including over-the-counter medications such as ibuprofen. Always read the information that comes with your medication to see if there are any medications you should avoid, or ask your doctor.[14]

Birth control pills and antidepressants are known to be safe and effective when used together. However, there is a small chance that unknown or rare side effects may occur while taking them.[15]

When in doubt, ask your doctor or pharmacist. They should be able to advise you.

Finding an Antidepressant That Works For You

When finding an antidepressant that works best for you, your doctor may consider: your particular symptoms, possible side effects, whether it has worked for a close relative, interactions with other medications, whether you’re pregnant or breastfeeding, other health conditions, cost and health insurance.[16]

Going Off of Your Antidepressants

If you want to cut down, let your doctor know and he/she will be able to help you manage it.

If you want to stop taking a medication or cut down your dose or, you should always go down slowly. “Sudden changes in your dose can greatly increase your risk of having another mood episode.”[17]

You should first ask yourself if this is the right time. “Are you feeling well? Is the level of stress in your life manageable? Do you feel supported by your family and friends?”[18]

As you cut down, monitor your mood and behaviours. Let your doctor know if you start to feel unwell or depressed again. If your mood goes down, it may not be the right time to go off the medication.


References

[1] Centre for Addiction and Mental Health. (2012). Antidepressant Medication. Retrieved from http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/antidepressant_medication/Pages/antidepressant_medication.aspx

[2] National Health Service. (2015). Antidepressants – When they are used. Retrieved from http://www.nhs.uk/Conditions/Antidepressant-drugs/Pages/What-it-is-used-for.aspx

[3] Mayo Clinic Staff. (2014). Antidepressants: Selecting one that’s right for you. Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046273

[4] Centre for Addiction and Mental Health, 2012

[5] Allen, A. (2011). Coping With Side Effects of Depression Treatment. WebMD. Retrieved from http://www.webmd.com/depression/features/coping-with-side-effects-of-depression-treatment#1

[6] Centre for Addiction and Mental Health, 2012

[7] Mayo Clinic Staff, 2014

[8] Centre for Addiction and Mental Health, 2012

[9] Page, A. (2012). Taking Antidepressants: Myths vs. Facts. HealthCentral. Retrieved from http://www.healthcentral.com/depression/c/458275/152610/taking-myths/

[10] Mayo Clinic Staff. (2015). Antidepressants: Safe during pregnancy? Mayo Clinic. Retrieved from http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/antidepressants/art-20046420

[11] ibid.

[12] Centre for Addiction and Mental Health, 2012

[13] ibid.

[14] National Health Service. (2015). Antidepressants – Cautions. Retrieved from http://www.nhs.uk/Conditions/Antidepressant-drugs/Pages/Cautions.aspx

[15] Ruddock, V. (n.d.). Antidepressants Mixed With Birth Control Pills. LoveToKnow. Retrieved from http://pregnancy.lovetoknow.com/wiki/Antidepressants_Mixed_with_Birth_Control_Pills

[16] Mayo Clinic Staff, 2014

[17] Centre for Addiction and Mental Health, 2012

[18] ibid.

Leave a Reply

Your email address will not be published. Required fields are marked *