Antidepressants improve symptoms of depression by affecting the brain chemicals associated with emotion, such as serotonin, norepinephrine and dopamine. The following information comes from NAMI, goodtherapy.org and other sources.
Selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) are newer antidepressants with fewer side effects than older drugs, but no medication is entirely free of side effects. Potential side effects of SSRIs and SNRIs include:
- Nervousness, agitation or restlessness
- Reduced sexual desire/difficulty reaching orgasm/inability to maintain an erection
- Insomnia, drowsiness
- Weight gain or loss
- Dry mouth
One antidepressant (Bupropion) affects mostly the brain chemical dopamine and is in a category of its own.
Meanwhile, older types of antidepressants, including tricyclics and monoamine oxidase inhibitors (MAOIs), may be prescribed by a mental health professional if newer medications do not seem to be effective. Common side effects of tricyclics include:
- Dry mouth
- Blurred vision
- Urine retention
- Increased appetite, leading to weight gain
- Drop in blood pressure when moving from sitting to standing, which can cause lightheadedness
- Increased sweating
MAOIs are the least-prescribed of all antidepressants because they can cause dangerously high blood pressure when combined with certain foods or medications. People taking MAOIs must watch their diets carefully to avoid potentially life-threatening complications. Off-limits foods typically include aged cheese, sauerkraut, cured meats, draft beer and fermented soy products such as miso, tofu or soy sauce. Some people may have to avoid wine and all forms of beer.
Some antidepressants may be useful for post-traumatic stress disorder, generalized anxiety disorder and obsessive-compulsive disorder but may require higher doses. Symptoms of depression that are part of a bipolar disorder need more careful assessment because antidepressants may worsen the risk of mania and provide little relief from depressive symptoms. As always, ask your doctor about what treatment options are right for you.
When will the medication work?
In the first few days, the person may have better sleeping and eating habits. In the first 1-3 weeks, the person may have better memory, sex drive, and self-care habits. They may also feel like they have more energy and start to have less anxiety.
After 2-4 weeks, the person may start to have a better mood, less feelings of hopelessness, and less suicidal thoughts. They may also start to feel interested in hobbies again. It may take 6-8 weeks for the medication to fully work.
What are the common side effects?
These are most common in the beginning, and usually get better within 1-2 weeks.
- Upset stomach, diarrhea
- Sleepiness or feeling more awake
Some antidepressants can cause sexual problems, such as a decrease in sex drive or problems with ejaculation.
How long do people need to take this medication?
Some people need to take medicine for up to 1 year after they feel better. Others need to take medicine long-term to prevent their symptoms of depression or anxiety from coming back. The length of time depends on how bad the depression or anxiety was, how long they had it, and how many times they have had depression or anxiety in the past.
Here are some of the medication names and their types, with some links to their descriptions in goodtherapy.org
- Selective serotonin reuptake inhibitors (SSRIs): These medications gradually increase the amount of serotonin, a neurotransmitter, in the brain. Common SSRIs include:
- Monoamine oxidase inhibitors (MAOIs): A less common variety of antidepressant drugs, MAOIs are often a last option with complex, treatment-resistant depression. Common MAOIs include:
- Emsam (selegiline)
- Marplan (isocarboxazid)
- Nardil (phenelzine)
- Parnate (tranylcypromine)
- Tricyclics (TCAs):These older antidepressant medications have been pushed to the sidelines by newer, generally safer medications. Still, some people do not respond to the new antidepressants, so TCAs may be prescribed. Tricyclic medications include:
- Serotonin norepinephrine reuptake inhibitors (SNRIs):These medications work by slowly increasing the amount of norepinephrine in the brain. Common SNRIs include:
- Pristiq (desvenlafaxine)
- Effexor (venlafaxine)
- Cymbalta (duloxetine)