A variety of antidepressant medications are available for prescription use. There is no single best antidepressant, and the best one for you depends on your symptoms and individual needs.
How are medications selected?
The type of drug prescribed will depend on your symptoms, the presence of other medical conditions, what other medicines you are taking, cost of the prescribed treatments, and potential side effects. If you have had depression before, your doctor will usually prescribe the same medicine that worked for you in the past. If you have a family history of depression, medicines that have been effective in treating your family member(s) will be considered.
Usually you will start taking the medicine at a low dose. The dose will be gradually increased until you start to see an improvement (unless side effects emerge).
What are the side effects?
The doctor prescribing your medicine will discuss its potential side effects with you, and will try to prescribe drug(s) with the least number of side effects for your health condition. Sometimes, more than one medicine may be tried before the desired benefits are achieved.
You will be monitored closely so that your doctor can detect the development of harmful side effects and make the necessary changes.
All medications – not just antidepressants - can cause side effects. So, keep in mind that your doctor prescribes the medication only if its expected benefits outweigh the risk of side effects. In general, side effects of antidepressant medications are uncommon, and if they occur, are mild. Some side effects decrease after you have taken the drug for a while. However, if side effects do not go away, they will once the drug is stopped. Be sure to discuss your concerns with your doctor before taking any medicine.
Side effects of selective serotonin reuptake inhibitors (SSRIs) and noradrenalin serotonin reuptake inhibitors (NSRIs) include:
- Nausea or vomiting
- Sexual problems including low sex drive or inability to have an orgasm
- Increased anxiety
Side effects of tricyclic antidepressants include:
- Dry mouth
- Blurred vision
- Increased fatigue and sleepiness
- Weight gain
- Muscle twitching (tremors)
- Hand shaking
- Bladder problems
- Increased heart rate
It is important to remember that the majority of patients taking antidepressants do not develop side effects; however, some do which requires careful monitoring of all patients. It is also important to note that you should not drink alcoholic beverages while taking antidepressant medicines, since alcohol can interfere with their beneficial effects.
Will I become addicted if I take antidepressants?
Antidepressant medicines are not addictive; they do not make you "high," have a tranquilizing effect, or produce a craving for more. They are not "happy pills."
How long will I have to take antidepressants?
Usually, these drugs must be taken regularly for at least 4 to 8 weeks before their full benefit takes effect. You are usually monitored closely during this time to detect the development of side effects and to determine the effectiveness of treatment.
In order to prevent a relapse of depression, medicines are generally prescribed for 6 to 12 months after a first-time depression. When you and your doctor determine that you are better, you should expect to continue the medication for at least 4 to 6 months more, after which your doctor may gradually taper you off your medicine. Once you and your doctor have determined it is safe for you to stop taking your medicine altogether, you should continue to be monitored during periodic follow-up appointments (about every three months) to detect any signs of depression recurrence.
Long-term treatment with antidepressant medicine may be recommended to prevent further episodes of depression in people who have already suffered from two or more episodes of major depression, especially if the episodes have been severe or life-threatening. A history of depression in one’s family is another factor that may convince your doctor to prescribe long-term treatment.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 7/16/2009…#9301