Antidepressants can cause a range of side effects, commonly including digestive issues (nausea, diarrhea, constipation), sleep problems (insomnia or drowsiness), headaches, dizziness, sweating, and significant sexual dysfunction (low libido, difficulty with arousal/orgasm). More serious, but rarer, risks involve increased suicidal thoughts (especially in young people), serotonin syndrome, hyponatremia (low sodium), hypomania, and potential interactions with other drugs or alcohol. Many initial side effects improve over time, but persistent sexual issues, known as PSSD, are a recognized risk.
Two recent reviews of research in this area concluded that discontinuation effects, sexual dysfunction, weight gain, and sleep disturbance (multiple long-wake periods) are adverse effects of long-term SSRI use.
Some of the most frequently reported SEs associated with the use of second-generation antidepressants include gastrointestinal SEs, such as nausea, diarrhoea, constipation, dyspepsia and abdominal pain (Uher et al., 2009).
Antidepressants are thought to work by increasing neurotransmitters like serotonin and noradrenaline. These are chemicals in the brain which can improve mood and emotion. But this process isn't fully understood. Increasing levels of neurotransmitters can also disrupt pain signals sent by nerves.
Suicidal feelings
There is a possibility that taking an antidepressant could make you feel suicidal. It may happen even if you didn't experience suicidal feelings before. This side effect is mainly with SSRI antidepressants. But it is a risk with all antidepressants.
Antidepressants are not usually recommended for children and young people under 18. In rare cases, they can cause thoughts about suicide and self-harm in this age group. There are concerns that some antidepressants can also affect brain development in children and young people.
Can antidepressants stop working? When depression symptoms improve after starting an antidepressant, many people need to continue taking the medicine a long time to keep symptoms from coming back. For some people, an antidepressant may simply stop working over time. This is called antidepressant tolerance.
The question of whether the brain returns to normal after antidepressants reveals the sophisticated nature of neurobiological adaptation and recovery. Current research demonstrates that while antidepressants create significant and sometimes long-lasting changes in brain function, these adaptations are not permanent.
Long-Term Treatment – For those with severe, recurrent depression or treatment-resistant depression, antidepressants may be used for several years or indefinitely. The decision to remain on long-term medication depends on how well the medication controls symptoms and the patient's mental health history.
Antidepressants change the way your brain uses certain chemicals (called neurotransmitters) to better regulate your mood and behavior. They can also rewire your brain through a process called neuroplasticity. This means your brain can form new connections between nerve cells.
In line with this, a pre-clinical trial has provided evidence that five different antidepressants (including two SSRIs) can affect both the balance and the integrity of the gut microbiome, and that both treatment effect and side effects could be modulated by the replenishment of different strains of probiotics (15).
Antidepressants usually need to be taken for at least 6 months after your symptoms have gone away. However, this should be reviewed by your prescriber regularly. People with severe or recurring mental illness might need to take antidepressants for longer.
Overview. Serotonin syndrome is a serious drug reaction. It is caused by medications that build up high levels of serotonin in the body. Serotonin is a chemical that the body produces naturally. It's needed for the nerve cells and brain to function.
Overall, citalopram appears to be the best-tolerated SSRI, followed by fluoxetine, sertraline, paroxetine, and fluvoxamine. The latter 2 drugs are associated with the most side effects and the highest discontinuation rates because of side effects in clinical trials.
Sertraline requires special attention to the risks associated with neurologic, psychiatric, and congenital disorders in clinical use. In addition to common AEs such as nausea, and tremor, newly identified adverse reactions such as genital anaesthesia, bruxism, and microscopic colitis should be guarded against.
Antidepressant Addiction Symptoms
Avoid driving or operating machinery. Avoid caffeine, tobacco and alcohol. Drink plenty of fluids. Take your antidepressant at bedtime if your doctor approves.
10 Signs Your Antidepressant Is Working
Potential Mental Health Benefits
Many people report feeling emotions more fully or feeling more like themselves after they stop taking antidepressants. Some people report positive changes in their thinking and cognitive abilities after stopping antidepressants.
Some antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), can cause short-term memory problems in certain individuals. Research shows that many people experience these side effects only while taking the medication, and the memory issues often go away when the treatment is adjusted or stopped.
Taking antidepressants may help to lift your mood. This can help you feel more able to do things that don't feel possible while you're depressed. This may include using other types of support for your mental health. See our page on treatments for depression to find other options which may help.
What are the alternatives to antidepressants?
The long-term side effects of antidepressants such as Zoloft can include emotional numbness, sexual problems, weight gain, reduced positive feelings, and/or suicidal thoughts.
To minimize the risk of antidepressant withdrawal, talk with your doctor before you stop taking an antidepressant. Your doctor may recommend that you gradually reduce the dose of your antidepressant for several weeks or more to allow your body to adapt to the absence of the medication.
SSRIs are the most commonly prescribed type of antidepressant. This is because they're effective and well-tolerated with mild side effects for many people. With many SSRIs available as generic products, they also tend to be more affordable. SNRIs and bupropion are also common choices for similar reasons.