Side Effects of Medication for Depression

Antidepressant medications have a variety of different side effects depending on what type of medication is being taken. There are also a range of side effects that are similar for all the types, as they are all designed to affect the levels of neurotransmitters in the brain. The four main categories of medication that can be prescribed include selective serotonin reuptake inhibitors (SSRIs), atypical antidepressants, monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs).

SSRIs

• Selective serotonin reuptake inhibitors affect the levels of serotonin in the brain by stopping it from binding to its receptors. These drugs (such as Prozac, Paxil and Zoloft) were developed fairly recently and have less serious side effects than many of the MAOIs and TCAs. SSRI side effects include nausea; vomiting; changes in appetite; weight loss or gain; dizziness; fatigue; changes in sleep patterns; apathy; decreased sex drive; impairment of the kidneys, liver or urinary tract; increased risk of bone fracture; increased depression or anxiety; increased suicide risk; tremors; headaches; restlessness; increased sensitivity to sun exposure; and changes in sweating. There are also reported long-term sexual dysfunction side effects that last after the medication is stopped.

Atypical Antidepressants

• This group includes serotonin-norepinephrine reuptake inhibitors (SNRIs). These medications, such as Wellbutrin, Pristiq, Cymbalta, Remeron and Desyrel, affect a combination of the neurotransmitters serotonin, norepinephrine and dopamine. Side effects can include weight loss or gain, nausea, constipation, decreased appetite, dry mouth, nervousness or confusion, headaches, allergic reactions, heart palpitations, seizures, fatigue, blurred vision, dilated pupils, sexual dysfunction, sleepiness, increased sweating, liver problems, increased blood pressure, dizziness and lightheadedness. Duloxetine (Cymbalta, Yentreve) should not be taken by people with liver disease or heavy alcohol use as it has a higher risk of causing liver damage.

MAOIs

• MAOIs such as Nardil, Parnate and Marplan have been in use since the 1950s and have more severe side effects and more dangerous drug and food interactions than the more recently developed SSRIs and SNRIs. They are not often prescribed anymore, though there are a few MAOIs that have been developed more recently that are a safer though somewhat less effective alternative. The side effects include weight gain or appetite problems, upset stomach, constipation, diarrhea, decreased sex drive, difficulty with sleep, dizziness, dry mouth, blurred vision, high blood pressure or changed or uneven heart rhythms, muscle twitching and restlessness. Foods that contain high levels of tyramine, such as chocolates, aged cheeses, pickles, beer, wine or certain meats should be avoided due to the potential for dangerous increases in blood pressure.

TCAs

• Tricyclic antidepressants such as Elavil, Norpramin, Sintamil and Stablon have been in use since the 1950s as well and also have more serious side effects than more recently developed antidepressants. Side effects include stomach and digestion problems, constipation, changes in weight or appetite, low blood pressure, sexual dysfunction, confusion, apathy, restlessness, dizziness, fatigue, difficulty urinating, dry mouth and nose, blurred vision, tremors, sweating and impaired cognitive abilities.

Warning

• All antidepressant drugs seem to increase the risk of suicide in children, so their use in anyone under 18 must be carefully considered and well supervised. SSRIs or SNRIs and MAOIs must not be taken together because of potentially serious drug interactions, and a period of two to five weeks should be allowed to pass if switching between these types of medications. All antidepressants also cause problems if stopped suddenly, so care must be taken to gradually lessen the dose over time before quitting.