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 common but serious mood disorder. It's not a lifestyle choice or a sign of weakness. Depression affects people mentally, emotionally, and physically. It changes how well nerve cells in certain parts of the brain work. Antidepressants usually work by increasing the levels of certain chemicals in the brain. They are called neurotransmitters. Serotonin is a natural antidepressant neurotransmitter present in the brain. It is the most common target for therapy. Certain antidepressants increase the levels of serotonin in the brain. Antidepressants can be lifesaving, but they must be taken under the care of a provider. The provider wants to make sure that they help with minimum side effects. 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 works 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 1 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 some 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. Common side effects include:

• Upset stomach (nausea)

• Headache

• Sexual problems

• Constipation

• Urination problems, mostly in people assigned male at birth

• 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. Never increase or decrease your dose to manage symptoms unless you talk with your provider. Remember 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.

• Ask about food and alcohol interactions. There are certain antidepressant medicines, particularly MAOIs, that require restriction of certain foods and alcohol with high levels of an amino acid called tyramine. That can dangerously increase blood pressure.

• 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.

• Saint John's wort. Saint 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. It can also interact with other antidepressants and other medicines in general. Talk with your provider before taking Saint 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.

• Keep your medicines secure. Get safety caps on your medicines. Store all medicines in their original packages. Keep all medicines in locked cabinets or containers. Consider buying a lock box or small safe to secure all prescription and over-the-counter medicines.

• 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 or call or text 988 if you start to have thoughts of suicide or you begin to think of ways to harm yourself. You will be connected to trained crisis counselors at the 988 Suicide & Crisis Lifeline. An online chat option is also available at www.988lifeline.org. You can also call Lifeline at 800-273-TALK (800-273-8255). Lifeline is free and available 24/7.

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