What are the side effects of antidepressant medications?

The provider prescribing your medicine will discuss its potential side effects with you. He or she 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 provider can detect the development of harmful side effects and make the necessary changes.

All medications – not just antidepressants – can cause side effects. Keep in mind that your provider prescribes the medication only if its expected benefits outweigh the risk of side effects.

Side effects, if they occur, are usually 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 provider before taking any medicine.

Classes of antidepressant medications and common side effects

Currently there are six different classes of medications approved to treat depression. These are:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin and noradrenaline reuptake inhibitors (SNRIs)
  • Tricyclic antidepressants (TCAs)
  • Monoamine oxidase inhibitors (MAOIs)
  • Norepinephrine and dopamine reuptake inhibitors (NDRIs)
  • Non-competitive N-methyl-D-aspartate receptor antagonist

SSRIs are among the most commonly prescribed medications. Some examples of SSRIs include sertraline (Zoloft®), paroxetine (Paxil®), fluoxetine (Prozac®) and citalopram (Celexa®). Side effects of selective serotonin reuptake inhibitors (SSRIs) include:

SNRIs treat depression as well as long-term pain and anxiety. Some examples of SNRIs include venlafaxine (Effexor®), desvenlafaxine (Pristiq®) and duloxetine (Cymbalta®). Side effects of SNRIs include:

  • Headache
  • Dizziness
  • Nausea
  • Heavy sweating
  • Dry mouth
  • Constipation
  • Insomnia
  • Sexual problems including low sex drive or inability to have an orgasm

TCAs were among the first antidepressants approved. Because other, newer antidepressants are associated with fewer side effects, TCAs tend to be prescribed less often. Some examples of these drugs includes nortriptyline (Pamelor®), amitriptyline (Elavil®), and imipramine (Tofranil®). Side effects of tricyclic antidepressants include:

MAOIs were the first antidepressants approved. Their use has largely been replaced by newer antidepressants, which are safer and have fewer side effects. Some examples of MAOIs include phenelzine (Nardil®), tranylcypromine (Parnate®) and isocarboxazid (Marplan®). Side effects of monoamine oxidase inhibitors (MAOIs) include:

  • Drowsiness
  • Dry mouth
  • Dizziness
  • Headache
  • Nausea
  • Insomnia
  • Diarrhea or constipation
  • Weight gain
  • Low blood pressure
  • Tremors
  • Increased sweating
  • Sexual problems including low sex drive or inability to have an orgasm
  • Bladder problems (difficulty starting urine flow)

NDRIs treat depression as well as seasonal affective disorder. It is often prescribed by doctors for many “off label” psychiatric uses including anxiety, bipolar disorder and attention deficit/hyperactivity disorder (ADHD). Bupropion (Wellbutrin®) is the only member of this drug class. Some of its known side effects include:

  • Headache
  • Insomnia
  • Dry mouth
  • Constipation
  • Nausea
  • Tiredness
  • Tremor
  • Increased sweating

Esketamine (Ketanest®, Spravato®) is a non-competitive N-methyl-D-aspartate receptor antagonist approved in 2019. This antidepressant is only available as a nasal spray and is to be used together with an oral antidepressant for adults whose depression has not able to be effectively treated with other drugs. Esketamine has the potential for abuse and misuse and is associated with an increased risk of suicidal thoughts and behaviors. It can only be administered in a certified medical office under the direct supervision of a healthcare provider. Esketamine is not available at pharmacies for at-home use. Some of its known side effects include:

  • Dizziness
  • Nausea
  • Sedation
  • Anxiety
  • Increased blood pressure
  • Dissociation (distortion of time, space, illusions)
  • Vomiting
  • Feeling drunk
  • Lack of energy

It is important to remember that most patients taking antidepressants do not develop side effects. However, all patients should be carefully monitored. Do not drink alcoholic beverages while taking antidepressant medicines. Alcohol may 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."

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