Antidepressants are a type of medication used to treat symptoms of depression, such as sadness and feelings of worthlessness. Antidepressants are also sometimes used to treat other conditions, such as anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder.
There are many different types of antidepressant medication. It’s a good idea to make sure you understand the benefits, risks, and side effects of each type of medication before taking them.
It can take several weeks before an antidepressant starts to work and before you feel the full effects. This is because the level of antidepressant in your body needs to reach a certain level before it starts working. During this time, you may experience some unpleasant side effects, or your symptoms may get worse during the first few days after starting treatment.
Should I Try Antidepressants?
Medically administered antidepressants, or medication as a treatment for depression, are one of the most commonly prescribed drugs in the United States. Antidepressants work by altering brain chemistry and affect both emotional and physical well-being.
There is a great deal of controversy surrounding antidepressant use, however. Many people believe that the medications are overprescribed, with little evidence to support their use. Others believe that antidepressant medications do not work for everyone and may cause serious side effects.
In order for antidepressants to be effective, they need to be taken regularly, according to the National Institute of Mental Health (NIMH). That’s why it’s important to discuss with your doctor whether you are experiencing adequate relief from your symptoms without taking the medication.
Antidepressants are one of the most commonly prescribed medications in the United States. More than 100 million prescriptions for antidepressants were written in 2012 alone.
Antidepressants are not for everyone, however. If you are suffering from an antidepressant-related side effect or weight gain, it may be time to try something else. Antidepressants can lead to suicidal ideation and should never be used without a doctor’s consent. There are many alternatives that can help you feel better and live a healthier, happier life.
Types Of Antidepressants
There are five classes of antidepressants: SSRIs, SNRIs, TCAs, MAOIs, and others. Each class has its own unique properties.
Serotonin is a neurotransmitter, which is a chemical that carries signals between nerve cells in your brain. SSRIs work by preventing the reabsorption of serotonin by nerve cells. This increases the amount of serotonin available to your brain and boosts feelings of well-being.
Examples include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro).
SSRIs work better than older antidepressant medications and have fewer side effects, so they are usually the first-choice treatment for depression.
SNRI antidepressants are a category of medications that work to treat depression and other mood disorders (such as anxiety) by increasing the levels of serotonin and norepinephrine in the brain.
Both serotonin and norepinephrine are neurotransmitters, which are naturally occurring chemical messengers that help send signals across your nervous system.
SNRIs are classified as reuptake inhibitors because they block the reabsorption of both serotonin and norepinephrine into your neurons. As these chemicals are left unabsorbed, they continue to circulate in the space between your neurons (known as the synaptic cleft). This leaves more of these chemicals available to bind to receptors on nearby neurons, increasing communication between cells.
SNRIs are effective for treating major depression and other mood disorders. They can also help with anxiety and panic disorders, fibromyalgia and chronic pain conditions, severe hot flashes, and obsessive-compulsive disorder (OCD).
TCA antidepressants are a type of antidepressant used to treat depression and anxiety. They have been around for a long time, with the earliest type dating back to the 1950s.
TCA antidepressants are known as tricyclic antidepressants because their chemical structures are composed of three rings of atoms.
Tricyclic antidepressants are considered an older class of antidepressant medications, as more modern types of antidepressants, known as SSRIs (selective serotonin reuptake inhibitors), have largely replaced them in first-line treatment for depression.
The first TCA approved by the U.S. Food and Drug Administration was imipramine (Tofranil), which is still available today. Other TCAs include:
- amitriptyline (Elavil)
- clomipramine (Anafranil)
- doxepin (Adapin, Sinequan)
- nortriptyline (Pamelor)
- protriptyline (Vivactil)
- trimipramine (Surmontil)
Monoamine oxidase inhibitors (MAOIs) are a class of antidepressant drugs prescribed for the treatment of depression. They are particularly effective in treating atypical depression. MAOIs prevent the breakdown of monoamine neurotransmitters, thus increasing their availability.
The first MAOI was discovered in 1952, and since then several different types have been developed. MAOIs were once considered to be among the most effective antidepressants available, but high dosages were associated with potentially fatal side effects such as hypertensive crisis and serotonin syndrome, so they fell out of favor following the introduction of safer drugs with similar efficacy.
In contrast to tricyclic antidepressants (TCAs), which act by inhibiting the reuptake of norepinephrine and serotonin, MAOIs inhibit the activity of monoamine oxidase, thereby preventing the breakdown of monoamine neurotransmitters (such as norepinephrine, serotonin, and dopamine) and thereby allowing them to accumulate within the brain.
The primary medicinal use of MAOIs is in the treatment of clinical depression. However, they can also be used in the treatment of anxiety disorders or social phobia.
Side Effects Of Antidepressants
Antidepressants are generally considered to be safe and effective, but you may experience some side effects. These side effects often go away within a few days or weeks of starting treatment.
Antidepressants can cause various types of side effects. These include:
Sexual Side Effects
Side effects that affect sexual function include loss of sexual desire (libido), erectile dysfunction (ED), and delayed orgasm or ejaculation. These are the most common types of sexual side effects of antidepressants. They can often be managed by switching to a different antidepressant or adjusting the dose of your current antidepressant.
Many antidepressants can cause weight gain as a side effect, especially tricyclic antidepressants, such as amitriptyline (Elavil). Some newer antidepressants — such as bupropion (Wellbutrin) — don’t appear to have this same effect on weight gain. If your medication is causing you to gain weight, talk to your doctor about switching medications or changing the dose of your current antidepressant.
Drowsiness And Fatigue
This is one of the more common side effects of many antidepressants, especially when you first start taking them. It tends to go away over time as your body adjusts to the medication. Switching medications or adjusting the dose may help manage this.
Dry mouth is one of the most common side effects of medications that treat depression, anxiety, and other mood disorders. Antidepressants can cause dry mouth because they affect the salivary glands and reduce saliva production. And while some specific medications don’t cause dry mouth, they may interact with other drugs that do.
If you’re experiencing dry mouth due to antidepressants, it’s important to talk to your doctor about your symptoms and treatment options. Depending on how long you’ve been taking them, you may be able to try a different medication or dosage. In other cases, your doctor may recommend additional treatments to help manage dry mouth or a combination of medications that work better for you.
Nausea And Vomiting
One of the most common side effects is nausea, which has been reported in up to 50% of people taking these medications. Nausea is often the first sign that your body is adjusting to the medication, and it usually goes away after a few weeks.
But if you’re experiencing nausea more than a month after starting your medication, or if it’s severe enough to interfere with your daily life, talk to your doctor about changing medications or dosage.
Diarrhea Or Constipation
Many different kinds of antidepressants cause diarrhea. The most common offenders are selective serotonin reuptake inhibitors (SSRIs), including sertraline (Zoloft), fluoxetine (Prozac), and paroxetine (Paxil).
Other classes of antidepressants can also cause diarrhea, including tricyclic antidepressants, monoamine oxidase inhibitors, and atypical antidepressants.
Antidepressants cause diarrhea by increasing the activity of the vagus nerve, which controls the movement of your intestines. Antidepressants work by blocking the reabsorption of serotonin in your brain.
This increases the levels of serotonin in your brain, which improves your mood. But because these drugs don’t discriminate between different types of nerves, they also affect nerves outside your brain — including those that control movement in your stomach and intestines.
Blurred Vision And/Or Eye Pain
This can occur when people start taking antidepressants since the medication increases the concentration of serotonin in synapses. As serotonin levels rise, some people report feeling dizzy or lightheaded, and a few say they have blurry vision.
“The blurred vision usually lasts a short time after beginning or increasing the dose of an antidepressant,” says Dr. James Phelps, a psychiatrist and neuroscientist who is an associate professor at Oregon Health & Science University. “It is not likely to be permanent.”
Dr. Phelps says that blurred vision may be more common with higher doses of antidepressants such as Prozac (fluoxetine), Zoloft (sertraline), and Celexa (citalopram). It also may occur when patients start taking Paxil (paroxetine) or other antidepressants that inhibit serotonin reuptake in the brain.
Antidepressants are not the only drugs that can cause this problem. Others include methyldopa (Aldomet), which is used to treat high blood pressure, and glaucoma medications such as timolol (Timoptic) and betaxolol (Betoptic).
Ringing In The Ears
For some people, taking an antidepressant can trigger a ringing in the ears tinnitus.
Tinnitus is a condition that causes you to hear sounds that don’t have an external source. The noises may be in one or both of your ears, and they may come and go or be constant. Ringing is the most common sound, but others include buzzing, humming, hissing, roaring, and clicking.
Tinnitus affects about 20 percent of adults. Many of them also have hearing loss from damaged hair cells in their ears. It’s more common among older adults and women than men, according to the U.S. National Institute on Deafness and Other Communication Disorders (NIDCD).
You might get tinnitus when you start taking antidepressants or if you increase your dosage of an antidepressant you’ve been taking for some time. That’s because some antidepressants are ototoxic, which means they’re toxic to hair cells in your inner ear that are responsible for sending sound information to your brain.
Muscle Aches And Pains
According to the Mayo Clinic, muscle aches are one of a variety of side effects that may be caused by antidepressants. These drugs work by affecting brain chemicals that influence mood. The structure and function of some nerve circuits are also affected, which can lead to side effects like muscle aches.
Muscle pain is not a common side effect of antidepressants, but it does happen.
In general, the more sedating an antidepressant is, the more likely it is to cause this kind of pain. The older tricyclic antidepressants (TCAs) — including Elavil (amitriptyline), Pamelor (nortriptyline), and Sinequan (doxepin) — are commonly associated with muscle aches.
The newer antidepressants have a lower risk for muscle aches, but it’s still possible. Generally speaking, the SSRIs (Prozac (fluoxetine), Zoloft (sertraline), etc.) are less likely to cause muscle aches than other classes of antidepressants, like the SNRIs (Cymbalta (duloxetine) and Effexor (venlafaxine)).
Sleep Problems (Either Insomnia Or Excessive Sleeping)
If you’ve recently started taking an antidepressant, you may have noticed some changes in your sleep habits. Perhaps you’re sleeping more than usual, or maybe you’re having a hard time falling asleep at night. You may even be waking up really early in the morning.
The good news is, these sleep problems are usually temporary and will subside as your body adjusts to the medication. The bad news is, there’s no way to know for sure how long it will take for these side effects to disappear.
“If your psychiatrist has prescribed an antidepressant and it’s not working for you because of the side effects, then I would say try to hold out for about six weeks,” says Dr. David E. Combs, assistant professor of psychiatry at Harvard Medical School and a staff psychiatrist at McLean Hospital in Belmont, Massachusetts. “That seems to be the magic number when we start seeing improvement in insomnia with antidepressants.”
Can I Use Antidepressants Indefinitely?
Long-term use of antidepressants is also tied to side effects. For example, a 2013 study found that people taking SSRIs for an average of 27 months — or more than two years — had a higher risk of bone fractures, especially in the upper body, compared with people who took a placebo.
For older adults, taking antidepressants for a long time may increase the risk of other health problems. A 2013 analysis found that people ages 60 and older who used antidepressants for five years or more had a 33 percent increased risk of developing dementia later in life.
And some studies suggest that people who take certain antidepressants for months or years may experience withdrawal symptoms when they stop taking them. These effects can be worse if someone quits “cold turkey” rather than gradually cutting back on the dose.
Is Exercise As Good As Antidepressants?
After a spate of recent studies suggested that exercise is as good as antidepressants at treating depression, a new study is trying to settle the score.
The review, which was published in the American Journal of Psychiatry on Tuesday, is the latest to compare exercise with antidepressant medications as a treatment for depression. The authors analyzed data from 10 trials on a total of 645 adults diagnosed with major depressive disorder and found that exercise reduced symptoms by 30 percent and antidepressant medication reduced them by 33 percent. Those reductions were on par with the results from previous reviews on the topic.
“We saw pretty much the same results across all trials,” said Dr. Madhukar Trivedi, director of the Center for Depression Research and Clinical Care at UT Southwestern Medical Center, who led the new study. “This tells us that exercise can be added to standard treatment.”
The review adds to growing evidence that vigorous physical activity can have an effect in treating depression. One meta-analysis published in 2017 looked at data from 33 studies and found that aerobic exercises like brisk walking and swimming improved symptoms among people with major depressive disorder. Another study last year found that running reduced depressive symptoms in mice.
What Does The Research Say?
A new study from Sweden says exercise is as effective as antidepressants in treating depression.
Antidepressants are the most popular treatment for moderate to severe depression. But if you don’t have access to medications, or you’ve tried them without success, what can you do?
The answer may be as close as your nearest park, gym, or living room. Exercise has long been known to be good for both your body and mind, but a new study from Sweden is the first of its kind to show that exercise might be just as effective an antidepressant as medication.
The study was published in the journal JAMA Psychiatry. Researchers followed 341 adults with mild to moderate depression over a 12-week period. Half of the participants took part in supervised aerobic exercise three times a week, while the other half were given sertraline, which is also known by its brand name Zoloft. Sertraline is used to treat major depressive disorders, obsessive-compulsive disorders, panic attacks, and post-traumatic stress disorder.
Researchers found that patients who exercised had similar improvements in mood and quality of life when compared to those who took sertraline. The results were consistent across all levels of depression severity and no side effects were observed.
If you’re on the fence about trying antidepressants for your mental health concerns, consider giving Exerpy a try. Exerpy focuses on using exercise as therapy for mental health conditions.