For Adults: Take Care with Antidepressants

Antidepressants are an important way to treat depression. Most adults with depression get better when treated with antidepressants. Treatment may be just with these medicines. Or it may be a mix of these medicines and psychotherapy or counseling.

Depression is a serious, complex brain disorder. It's not a lifestyle choice or a sign of weakness. Depression changes how well nerve cells in certain parts of the brain work. Antidepressants help some of those brain cells work better. They also change how certain chemicals in the brain called neurotransmitters work. Antidepressants are strong medicines. They affect people mentally, emotionally, and physically. These medicines must be taken with care to make sure they work as they should. Taking them as directed also makes it less likely that you will have any serious side effects.

Many types of antidepressants are available. Sometimes you and your healthcare provider may need to try a few to find the one that's best for you. Also, these medicines take time to work. It may take several weeks to a couple of months before your symptoms start to get better. Your provider will help you find the one medicine or a combination of medicines that work.

It's important to take antidepressants exactly as prescribed. Talk with your healthcare provider and pharmacist about your symptoms. Tell them about how you are using these medicines and if you have any questions.

Many choices

These are some of the antidepressants that are available to treat depression:

• Tricyclic antidepressants

• Selective serotonin reuptake inhibitors (SSRIs)

• Serotonin and norepinephrine reuptake inhibitors (SNRIs)

• Norepinephrine and dopamine reuptake inhibitors

• Tetracyclics

• Monoamine oxidase inhibitors (MAOIs)

Possible side effects

Most antidepressants cause side effects. Many of the side effects get better after you take the medicine for a period of time. Ask your healthcare provider or pharmacist what side effects to expect. Ask what side effects you should report. Don't stop taking medicines or take less of them because of side effects. Always check with your provider first. Different medicines have different side effects. Among common side effects are:

• Upset stomach (nausea)

• Headache

• Sexual problems

• Constipation

• Urination problems, mostly in men

• Dizziness

• Sleepiness or problems falling asleep

• Dry mouth

• Restlessness

• Blurred eyesight

Medicine tips

Tips include the following:

• Stick with your medicine. It often takes 8 weeks before you start feeling better. Keep in mind that you may need to try another medicine or combination of medicines. Keep in touch with your provider so your symptoms and medicines can be successfully managed.

• Stay away from alcohol. Don't drink alcohol while take antidepressant medicines. 

• Ask about medicine interactions. Antidepressants can have an effect on many other medicines. And many medicines can affect antidepressants. When you're taking an antidepressant, tell your healthcare provider and pharmacist about all the other medicines you take. This includes over-the-counter medicines and herbal health products.

• St. John's wort may be an option. St. John's wort is an herbal product that some people use for mild depression. It’s not approved by the FDA to treat depression. It can have serious side effects and can interact with other antidepressants and other medicines in general. Talk with your provider before taking St. John's wort. 

• Follow instructions exactly. It’s very important to take an antidepressant exactly as prescribed. This can even mean at a certain time of day. You should never stop taking your medicine without checking with your healthcare provider. If you stop, your depression could come back. You may be at risk for suicide. Stopping your medicine could cause symptoms from the sudden withdrawal. The safe way to stop taking an antidepressant is to taper off how much you take. Your provider will tell you how to do this.

• Follow any warnings carefully. Some antidepressants cause drowsiness. This can make some activities like driving dangerous. Call your healthcare provider right away if your depression gets worse. Also call your provider right away if you start to have thoughts of suicide or you begin to think of ways to commit suicide.

Tell your healthcare provider if you become pregnant or start to breastfeed a child. You may have to change medicines.