How will my doctor choose an antidepressant for me?
Your doctor will probably think about the following 10 points when choosing an antidepressant medicine for you:
- If you were depressed before and a certain antidepressant worked well, that antidepressant might be the right choice of medicine for you again.
- If any of your brothers or sisters, parents, uncles or aunts had depression and a certain antidepressant worked well for them, that medicine might work for you too.
- The choice of an antidepressant depends on your health. If a certain antidepressant would have a bad effect on a health problem you have, that medicine wouldn’t be the right choice for you.
- Antidepressants can have side effects. The right medicine for you may be the one that gives you the fewest side effects.
- The choice of an antidepressant depends on how often you have to take it. The less often you have to take the medicine, the easier it is for you to take all the doses you need to treat your depression.
- Some antidepressants cost more than others. Your doctor will choose an antidepressant that works for you and that you can afford.
- Your doctor will want to choose a medicine he or she has experience prescribing.
- Your doctor will choose an antidepressant that will help you with symptoms like sleeplessness, anxiety and lack of energy.
- If you’re taking other medicines, your doctor will consider how an antidepressant will work with these other medicines.
- Some antidepressants don’t work well with certain foods. If your doctor gives you one of these antidepressants, he or she will let you know which foods you should stop eating.
Are antidepressants tranquilizers or “uppers”? Can I get addicted to them?
No. These drugs aren’t tranquilizers. They don’t give you a “high.” They aren’t addictive.
Do antidepressants cause side effects?
Yes. All antidepressants have some side effects. However, not all people taking antidepressants get these side effects. Most of the side effects happen in the early weeks of therapy and lessen over time.
What are some of the common side effects of antidepressants?
Different antidepressants can cause different side effects. Possible side effects may include the following:
- Bladder problems
- Blurred vision
- Dizziness when standing up
- Dry mouth
- Excessive tiredness
- Feeling of weakness
- Hand tremors
- Increased heart rate
- Increased sleepiness
- Muscle twitching
- Sexual dysfunction (inability to ejaculate or to have an orgasm)
- Weight gain
What if the side effects don’t go away?
Talk to your doctor. He or she may change your dosage, or you might try another medicine to get rid of the side effects.
How will I know if my antidepressant is working?
You will be able to sleep better. You’ll be better able to meet your day-to-day obligations and take care of yourself. You will have more energy. Your weight problems will get better, and your appetite will be closer to normal. You will have an increased desire to engage in life. You and your family and friends will notice these changes. Be patient, though. It may take some time to get back to the way you felt before the depression.
How long will I take the antidepressant?
Antidepressants are usually taken every day. It can take up to a month to see the full results of taking an antidepressant. You may need to try different kinds or amounts (dosages) to find the antidepressant that works best for you. Your doctor will let you know how long to take your antidepressant. If this is the first time you have been treated for depression, you will probably continue to take this medicine for about 6 months after you begin to feel better. If this is the second time you’ve been depressed, you might keep taking the medicine for at least a year. Depression that comes back a third time may require you to continue taking an antidepressant for a long time.
You can get unwanted side effects if you stop taking your antidepressant suddenly. If you want to stop taking your medicine, talk to your doctor first. Your doctor can help you avoid any side effects from stopping the medicine too quickly.
Can I drink alcohol when I’m taking an antidepressant?
You should be careful about drinking alcohol until you know how the medicine affects you. The affects of alcohol can combine with the affects of the antidepressant and cause problems. Regular heavy drinking can make it harder to treat the depression and certain kinds of medicine can lead to seizures for heavy drinkers. Talk to your doctor about drinking while taking an antidepressant.
Will antidepressants affect my other medicines?
Antidepressants can have an effect on many other medicines. If you’re going to take an antidepressant, tell your doctor about all the other medicines you take, including over-the-counter medicines and herbal health products (such as St. John’s wort). Ask your doctor and pharmacist if any of your regular medicines can cause problems when combined with an antidepressant.
What is antidepressant discontinuation syndrome?
Antidepressant discontinuation syndrome can occur if you suddenly stop taking your antidepressant medicine. Antidepressant discontinuation syndrome is not dangerous or life threatening and usually goes away within 1 week.
The symptoms include:
- Feelings of sadness
- Nausea and vomiting
Which antidepressants can cause this problem?
You are more likely to have a problem if you stop taking certain antidepressants, such as paroxetine and sertraline, but you can get symptoms from stopping any antidepressant medicine.
What can I do if I have antidepressant discontinuation syndrome?
If you accidentally missed a dose of your antidepressant medicine, start taking it again as soon as possible. If you are out of medicine, call your doctor so he or she can refill your prescription.
If you decided to stop taking your antidepressant medicine on your own, talk to your doctor about why you stopped. For example, was the medicine causing an unpleasant side effect? Your doctor can help by altering your dosage or suggesting another type of antidepressant.
If your doctor recommended that you take a lower dosage of your medicine and you are experiencing symptoms of antidepressant discontinuation syndrome, talk with your doctor. You may need to take a higher dosage for a period of time before weaning your body from the medicine completely.
How do I keep this from happening again?
Take your medicine exactly as your doctor tells you. If you want to stop taking your medicine, talk to your doctor first. Just because you are unable to stop taking your medicine all at once does not mean that you are addicted. Your body often needs time to adjust to lower levels of the medicine. This is why your doctor may recommend tapering off of antidepressant medicine rather than abruptly stopping it.
Are antidepressants safe for children and teens?
In some cases, the use of antidepressants has been linked to an increase in suicidal thoughts and suicidal behavior in children, teens and young adults. The Food and Drug Administration (FDA) now requires antidepressants to carry a warning about the risk of suicide in children, teens, and young adults 24 years of age or younger. However, this doesn’t mean that people in this age group should not take antidepressants. It does mean that they should be carefully monitored by their doctors and loved ones while they are on an antidepressant.
Many doctors will want to see a child or teen sometime in the first few weeks after starting an antidepressant to assess any risk for suicide. If you are worried that your child may be suicidal, call your doctor right away or take your child to the nearest emergency room.
Are antidepressants safe for any woman who has depression?
If you’re planning to get pregnant, talk to your doctor about your medicines before you try to get pregnant. If you accidentally get pregnant while you’re taking an antidepressant, tell your doctor right away. Your doctor will know if your particular antidepressant is safe to take.
All medicine you take passes into your breast milk. If you are planning to breastfeed or you currently breastfeed, talk to your doctor about your medicine.
In most cases, it’s okay to take birth control pills or hormone replacement therapy (also called HRT) at the same time as depression medicines. Taking hormones may even help some depressed women feel better. However, if your birth control pills seem to be causing symptoms of depression, discuss this with your doctor. He or she may suggest you use another method to prevent pregnancy for several months in order to find out if your birth control pills are causing depression.
This content has been supported by Forest Laboratories Inc.
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.