7 Antidepressant Side Effects
Antidepressants can be effective, but you want to watch for side effects of these prescriptions for depression.
Antidepressants called selective serotonin reuptake inhibitors (SSRIs) are among the most common medications prescribed in America today. For the most part, these medications are safe and effective, but all medications have side effects.
“Side effects from antidepressants depend on the class of medication you are using, but in most cases when we talk about side effects, we are talking about SSRIs,” says Madhukar Trivedi, MD, a psychiatry professor and director of the Depression Center at the University of Texas Southwestern Medical Center in Dallas. According to a report in the journal Psychiatry, about 40 percent of people taking antidepressants have side effects, and about 25 percent of those side effects are considered very bothersome. Two of the most common ones (sexual side effects and weight gain) are serious enough to cause people to stop or change antidepressant medications.
Here are seven important antidepressant side effects you need to be aware of:
Physical Symptoms. When you first begin antidepressant treatment, depression medication side effects can be physical symptoms like headache, joint pain, muscle aches, nausea, skin rashes, or diarrhea. These symptoms are usually mild and temporary. A study published in the journal Clinical Therapeutics looked at more than 40,000 people who had recently started on antidepressants. The most common early side effects of theses meds were headache and nausea. “Many people build up a tolerance to these early side effects, and they rarely require discontinuation of medications,” says Dr. Trivedi.
Sleep Disturbance. “Many people notice trouble sleeping when they first start taking an antidepressant — trouble falling asleep or that they wake up easily during the night,” says Trivedi. Other types of depression medication-related sleep disturbances common with SSRIs include nightmares and sleepwalking. A review of sleep disturbances in people taking SSRIs, published in the journal Frontiers in Psychiatry, reported that about 22 percent of those on these prescription meds experience some type of sleep disturbance.
Daytime Sleepiness. “Daytime sleepiness can be a side effect of sleep disturbance at night or a direct sedative effect of an antidepressant,” explains Trivedi. “If an antidepressant causes sedation, taking it at bedtime may solve the problem.” Medication side effects of SSRIs in particular can include both sedation that causes daytime sleepiness and insomnia that causes nighttime wakefulness. About 25 percent of people on SSRI meds will have one or both of these two side effects.
Migraine Headache. Because migraines tend to be more common in people with depression, Trivedi says, “people who take medications for migraines need to be careful when taking SSRIs.” Medications used for migraine treatment, called triptans, and SSRIs both increase the brain chemical serotonin. Serotonin syndrome, which causes flushing, rapid heart rate, and headache, can occur if these medications are taken together. Ask your doctor about how to avoid serotonin syndrome if you’re taking prescription meds for both conditions.
Weight Gain. “Weight gain is a late side effect of antidepressants and one of the most common reasons that patients stop taking them or need to change medications,” says Trivedi. “Getting 30 minutes of exercise on most days of the week is the best remedy.” The likelihood of gaining weight depends on the antidepressant you’re taking. With paroxetine hydrochloride (Paxil), a commonly used depression medication, about 25 percent of people will gain more than 7 percent of their body weight.”
Suicide. The risk that taking an antidepressant will increase the risk of suicidal thinking has been extensively studied. According to most of the research, when compared with taking a placebo, taking an SSRI or another antidepressant doubles the risk for suicidal thinking. The overall risk of this depression medication side effect for children, teens, and adults is 2 to 4 percent. One reason why antidepressants may lead to suicide is that they may give a person enough energy to carry out a suicide plan. Regular follow-up with your doctor is the best way to prevent this side effect.
Sexual Side Effects. Sexual side effects are the most common long-term side effects caused by SSRIs. They include decreased sexual desire, delayed ejaculation in men, and the inability to have an orgasm in women. Up to 60 percent of people on SSRIs may have one of these depression medication side effects. “Sexual side effects are one of the long-term side effects that many people cannot tolerate,” Trivedi says. “For any side effect, early or late, you need to work with your doctor; there are usually options that can help. But discontinuing your medication on your own is never a good option.”