If you have depression, your doctor may prescribe medicine to treat it. This medicine is called an antidepressant. There are many types of antidepressants. Finding the one that’s right for you can take time. It’s important to work with your doctor to find it.
Path to improved health
Your doctor will consider many factors when choosing the antidepressant medicine to give you. He or she will think about the following:
- If you were depressed before and a certain antidepressant worked well, that medicine might be the right choice for you again.
- If any of your brothers, 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. Certain antidepressants may 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 may be 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 your budget.
- Your doctor will likely 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.
Keep in mind that antidepressant medicines aren’t tranquilizers or “uppers.” You won’t get a “high” when you take them. Also, they’re not addictive.
You’ll know if your antidepressant is working based on how you feel. You’ll be able to sleep better. You’ll have more energy to meet your day-to-day obligations. You can take care of yourself. Your appetite will be closer to normal. You’ll 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.
It is important to remember that antidepressants can help with symptoms of depression. These medicines work best when you try to have an active lifestyle with exercise, get eight hours of sleep a night, and eat healthy foods. Your doctor may also recommend working with a counselor to help you improve the thoughts of depression.
How to take antidepressants
Antidepressants are usually taken every day. It can take 1 or even 2 months to see the full results. 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 at least 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 longer 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. He or she can try to help you avoid these side effects.
Alcohol and antidepressants
Talk to your doctor about drinking alcohol while taking an antidepressant. You should be careful about drinking until you know how the medicine affects you. The effects of alcohol can combine with the effects of the antidepressant and cause problems. Regular heavy drinking can make it harder to treat depression. Certain kinds of medicine can lead to seizures for heavy drinkers.
Antidepressants and other medicines
Antidepressants can have an effect on many other medicines. If you’re taking an antidepressant, tell your doctor about all other medicines you take, including over-the-counter (OTC) medicines and herbal health products (such as St. John’s wort). He or she can let you know if your regular medicines may cause problems when combined with an antidepressant.
Antidepressants for children and teens
In some cases, the use of antidepressants has been linked to an increase in suicidal thoughts and 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 shouldn’t take antidepressants. It means they should be carefully monitored by their doctor and loved ones while taking the 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’re worried your child may be suicidal, call your doctor right away or take your child to the nearest emergency room.
Things to consider
All antidepressants have some side effects. However, not all people taking antidepressants have these side effects. Most of the side effects happen in the early weeks of therapy and lessen over time. You may experience 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
Talk to your doctor if these side effects don’t go away. He or she may change your dosage or suggest another medicine to get rid of the side effects.
Considerations for women
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 taking an antidepressant, tell your doctor right away. Your doctor will know if your particular antidepressant is safe to take.
Most medicines you take can pass into your breast milk. That means it may be passed on to your baby. If you’re 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 it with your doctor. He or she may suggest you use another method to prevent pregnancy for several months to find out if your birth control pills are causing depression.
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. It usually goes away within 1 week. The symptoms include:
- feelings of sadness
- nausea and vomiting
You’re more likely to have antidepressant discontinuation syndrome if you stop taking certain antidepressants, such as paroxetine and sertraline. However, you can get symptoms from stopping any antidepressant medicine.
If you accidentally missed a dose of your antidepressant medicine, start taking it again as soon as possible. If you’re 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? Did it cost too much? Your doctor can help by altering your dosage or suggesting another antidepressant.
If your doctor recommended you take a lower dosage of your medicine and you’re 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.
To keep antidepressant discontinuation syndrome from happening again, take your medicine exactly as your doctor tells you. If you want to stop taking it, talk to your doctor first. Just because you’re unable to stop taking your medicine suddenly doesn’t mean you’re addicted. Your body often needs time to adjust to lower levels of the medicine. That’s why your doctor may recommend tapering off of an antidepressant rather than abruptly stopping it.
Questions to ask your doctor
- How can I know if I have depression?
- Are there ways to treat depression that don’t involve medicine?
- If I am depressed, should I also be talking to a mental health professional?
- Are there coupons I can use to help lower the cost of antidepressants?
- How long will it take to get the dosage right for my medication?
- Are there any special genetic tests I can take to see which antidepressant is right for me?
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.