1. ‘Ugh — Suddenly My Head Hurts’
During the first few days of taking your new prescription, you might find that you have a headache. All antidepressants have the potential to produce this side effect for a few days, says Boadie Dunlop, MD, an adjunct professor of psychiatry and behavioral sciences and the director of the mood and anxiety disorders program at the Emory University School of Medicine in Atlanta.
He suggests taking acetaminophen (Tylenol) to help, adding that this symptom usually gets better within the first week or two.
2. ‘My Stomach Is Upset, and I Have Diarrhea’
3. ‘I Have the Shakes’
A small number of people find that their medication causes shakiness or tremors. “These can persist and can prevent people from continuing with their medication,” Dunlop says. If you develop this symptom, contact your doctor to discuss changing your dose, or the drug itself.
4. ‘I Have a Dry Mouth and Really Bad Breath’
Dry mouth is a common side effect of antidepressants. For most people, dry mouth will improve within a few weeks of taking antidepressants, or even earlier, says Karen Lim, MD, a psychiatrist specializing in general and child and adolescent psychiatry based in Fresno, California.
In the meantime, Dr. Lim suggests sipping on water routinely, sucking on ice chips and sugarless candies, popping mints, and chewing sugarless gum.
“If dry mouth persists beyond your first few weeks on an antidepressant, or if it is particularly severe, I would speak to your doctor as soon as possible,” says Lim, adding that your dentist may also be able to help.
5. ‘I’m Still Sad’
Of all antidepressant problems, this may be the thorniest to untangle. If you’re continuing to experience depression symptoms despite taking an antidepressant, there are a number of possible explanations to consider:
- You got the wrong diagnosis. “When someone has depression that doesn’t respond to treatment, the first thing you do is step back and make sure you have the right diagnosis,” Dr. Combs says. Your psychiatrist might do more tests to make sure some important clues weren’t missed the first time around. Medical conditions, including stroke, heart disease, hypothyroidism, and certain nutritional deficiencies, as well as some medications, can be the underlying cause of depression.
- Your medication hasn’t kicked in yet. It takes time for an antidepressant to become effective — typically a few weeks, but sometimes as many as eight weeks or more. Check with your doctor to find out whether you need to wait a bit longer.
- You’re drinking alcohol or using recreational drugs. These substances can interfere with the effectiveness of your depression treatment, so you’ll need to quit if you want complete success.
- You’re not in therapy. Although medication can help, you might also need to talk with a therapist to help you figure out how to cope with issues in your life that are causing you to feel sad or anxious. Some evidence suggests that the combination of medication and psychotherapy is more effective than either method alone.
- You’re taking the wrong medication. You might find relief by switching antidepressants or adding another medication, such as a thyroid drug or a mood stabilizer. Talk about this with your doctor.
- You need to try something new. Ask your doctor whether you might benefit from other approaches; even unconventional ones. For example, dance movement therapy and other dance-based therapies have been shown to help manage depression in adults, according to research.
6. ‘I’m Not Sad, but I’m Not Happy Either’
Approximately 40 to 60 percent of people who take an SSRI or a serotonin-norepinephrine reuptake inhibitor (SNRI) medication for depression experience emotional blunting — a feeling of being depleted of all emotions, including the good ones, according to research.
You don’t have to lose your ability to feel joy in order to manage depression: Emotional blunting is best addressed by switching to a different class of antidepressants, adding a second medication, or talking with a therapist, Combs says.
7. ‘My Antidepressant Is Making Me Gain Weight’
If you have a history of being overweight, you’re more likely to gain weight while on an antidepressant, so choose an antidepressant that is weight-neutral, Combs says. If that’s not an option, she suggests getting counseling on diet and exercise. And exercise can also help reduce symptoms of depression, potentially adding to the results you’re seeing from treatment with an antidepressant.
8. ‘Sex Tonight? No Way!’
Many people struggling with depression lose interest in sexual activity, but some antidepressants can also lower their libido further or make it difficult to respond sexually. Doctors don’t always warn their patients about this effect, Combs says, and it can be very frustrating. Some people are willing to accept it as a temporary trade-off for successful depression treatment, but most want solutions.
Consider switching antidepressants, trying a different dosing schedule (with the help of your doctor), scheduling sex around times when the medication is least likely to affect you sexually, taking other medications to improve sexual response, or meeting with a sex therapist.
9. ‘I’m Up All Night’
“Some antidepressants are identified as activating, and some are sedating,” Combs says. Finding the right match for you is key. A sedating antidepressant, for instance, might be a good bet for someone who is having problems falling asleep.
10. ‘I Want to Stop Taking My Meds, but I’m Afraid My Depression Will Come Back’
Once you start feeling better, you’ll likely want to quit taking antidepressants. But Dunlop says that you need to be stable on antidepressants for at least six months first, to reduce the risk of experiencing another bout of depression in the future.
Although antidepressants are only temporary for most people, you should never stop taking them (or any prescription medication) without the guidance of a doctor. Usually, the best approach is to reduce your dose in increments, as directed by a clinician. Stopping cold turkey could result in unwanted side effects and risk a recurrence of depression, Dunlop says.
11. ‘Now I Have Anxiety’
Some antidepressants can have stimulating effects, resulting in restlessness, anxiety, and agitation, says Indra Cidambi, MD, the medical director and founder of Center for Network Therapy, a New Jersey–based outpatient addiction and mental health treatment facility.
“One of the goals of antidepressants is, after all, to give you more energy to accomplish your daily tasks,” Dr. Cidambi says. But sometimes people taking certain antidepressants just can’t relax or even sit still when they want to. If this is the case, it needs to be addressed, she says.
If you are experiencing increased restlessness or anxiety after starting an antidepressant, speak with your doctor. It could be a side effect called akathisia that needs to be addressed, because feeling restless on top of depression can lead to increased risk of self-harm.
Depending on the cause and severity of the restlessness or anxiety, your doctor may have different suggestions. “Working out, yoga, or meditation is usually enough to drain away the excess energy, but if that does not work, you could ask [your] doctor to prescribe nonaddictive sedatives or adjust the dosage of antidepressants,” Cidambi says. Sometimes, this may mean a different form of treatment is needed.
If you’re having high energy levels accompanied by racing or impulsive thoughts, it may be a sign of a more serious condition, such as bipolar disorder, says Cidambi. She recommends talking to your doctor if you have these symptoms.
12. ‘I Want to Die’
Regardless of what might be prompting the suicidal thoughts, call your doctor immediately if you start to experience worsening depression symptoms, including suicidal thoughts or thoughts of harming yourself or others, Dunlop says. You can also get help at any time by calling or texting the 988 Suicide & Crisis Lifeline.
If you’re running into a problem with your antidepressants, there’s likely a solution — so don’t ignore it. Get to the bottom of it.
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