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.
Zoloft, Lexapro, and Celexa may have fewer and milder side effects than other SSRIs, although they can still cause side effects like insomnia, sexual dysfunction, and bleeding in some people. Individual responses to SSRIs vary significantly. What works well for one person may cause side effects in another.
Zoloft seems to cause diarrhea more than other antidepressants. One study found that 14% of people taking Zoloft developed diarrhea, compared to about 7% for other SSRIs.
Serious side effects
an allergic reaction (anaphylaxis) – causing symptoms such as a swollen throat or tongue, a raised, itchy rash and difficulty breathing. serotonin syndrome – a rare but serious condition that causes a fast heartbeat, sweating, shaking, twitching muscles and feeling confused or agitated.
In general, these antidepressants are options during pregnancy: Certain selective serotonin reuptake inhibitors (SSRIs). SSRIs usually are an option during pregnancy. These include citalopram (Celexa), sertraline (Zoloft), escitalopram (Lexapro) and fluoxetine (Prozac).
Lexapro (escitalopram) is an SSRI. It's one of the safest antidepressants to take during pregnancy. But if you're unable to take Lexapro, your prescriber may suggest trying another SSRI. Potential pregnancy-safe alternatives include Celexa (citalopram) and Zoloft (sertraline).
The National Perinatal Mental Health Guideline identifies two types of antidepressant medication that can be used in pregnancy. Namely, this includes selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs).
Nausea. The most common side effect of sertraline in clinical trials was nausea. About 25% of people taking sertraline experienced it. It's most likely to occur when you first start sertraline or right after a dose increase.
Antidepressant drugs mess with our hypothalamus – the gland in our brain that controls things like our internal temperature and sweat. During a heat wave, this gland can get confused. You might start burning too much energy, as if it's cold outside.
Lexapro is FDA-approved for depression and generalized anxiety disorder (GAD), while Zoloft is approved for a broader range of conditions, including major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), and ...
Prozac. Prozac causes less weight gain than other SSRIs. Some people may even lose weight during the first few months of treatment (although they usually regain that weight over time). Prozac is also the SSRI that is least likely to cause nausea and stomach upset.
The answer is in your genes. Not all patients experiencing mood swings or depression have abnormally low levels of serotonin in the brain. Even though they have normally functioning liver enzymes that metabolize SSRIs properly, they are still unable to tolerate these medicines, even at low concentrations.
Tricyclic antidepressants like amoxapine, doxepin, and clomipramine have been shown in studies to create as much as a 58% decrease in salivary flow. SSRIs like fluoxetine, citalopram, and sertraline don't cause as much dry mouth as tricyclic antidepressants, but they can still cause around a 32% decrease.
They are not more effective than other antidepressants, but they are usually well-tolerated by most people. This means that most people find that side effects are not too troublesome. Examples include citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine and sertraline.
In summary, mirtazapine works via multiple pathways (serotonin, norepinephrine, and histamine) which can reduce anxiety and improve sleep, whereas sertraline works by selectively enhancing serotonin which lifts mood and eases anxiety.
The FDA label for sertraline specifically acknowledges that the medication may cause difficulty concentrating, memory changes, and confusion as potential side effects. These symptoms can occur at therapeutic doses and may persist throughout treatment for some individuals.
Here are a few things that can help keep you comfortable:
Several groups of drugs are known in the literature that can cause BO through excessive sweating such as antidepressant medications (bupropion hydrochloride, venlafaxine hydrochloride ect.), non-steroidal anti-inflammatory drugs (ketoprofen and naproxen), analgesic (codeine), omega-3-acid ethyl esters, leuprolide ...
It's common and safe to start taking antidepressants again after stopping, especially if you are experiencing a resurgence in signs of depression or anxiety, under the supervision of a doctor.
If you have been taking sertraline for more than a month and you continue to feel very tired, sleepy or struggle to function during the day, you should go back to your doctor and discuss what changes could be made to help. This may include switching to a different medication.
Summary of Black Box Warnings
In short-term studies, antidepressants increased the risk of suicidality in children, adolescents, and young adults when compared to placebo. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24.
IMPORTANT WARNING: has been expanded. Medications such as sertraline may increase the risk of suicidal thoughts and actions. This increase was found in children, teenagers, and young adults (less than 24 years of age). The risk may be more likely with the first few months of treatment and when the dose is increased.
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.
There are reports of more than 25,000 pregnancies exposed to sertraline. Most studies have not found a higher chance of birth defects when sertraline is used in pregnancy. Other studies have suggested a higher chance of birth defects, including heart defects.
Iceland had the highest antidepressant consumption rate in 2010 and 2020 and the steepest increase. Besides the many reasons joined to other countries, this trajectory is probably due to high depression rates for both women and men [28].