Side Effects of Depression Meds

There are four general types of medications that are prescribed for depression. They all effect the levels of at least one or more neurotransmitters in the brain that can change mood. These antidepressants can help alleviate symptoms, but they do not cure the problem. In addition, they have been found to work best when combined with psychotherapy. They seem to help the most for people with very severe depression. The potential usefulness of depression medications, however, must be weighed against their possible side effects.

Selective Serotonin Reuptake Inhibitors

• Currently the most commonly prescribed selective serotonin reuptake inhibitors (SSRIs) include Lexapro, Prozac, Celexa, Paxil, Zoloft and Luvox. They effect the levels of serotonin that are active in the brain by blocking their absorption into the presynaptic cells. While they have fewer side effects than other antidepressants, SSRIs also can have long-term negative effects on the serotonin receptors. Side effects include nausea, changes in appetite, diarrhea, weight gain, headaches, dizziness, sexual dysfunction, problems with sleeping or feelings of anxiousness, apathy or irritability. In addition, SSRIs increase the risk of bone fracture, and can impair the liver, urinary tract or kidneys. They must not be taken in conjunction with monoamine oxidase inhibitors as this will cause serotonin syndrome, which can be fatal.

Tricyclic Antidepressants

• Tricyclic antidepressants (TCAs) have been used since the 1950s, and effect the levels of serotonin, norepinephrine and dopamine by inhibiting their reabsorption by receptors. While they have more side effects than SSRIs, they can be effective when the depressed person does not respond to SSRIs. Vivactil, Aventyl, Norpramin and Sinequan are the most commonly prescribed TCAs. Side effects include dry mouth and nose, blurred vision, nausea, vomiting, problems with digestion and appetite, constipation, weight gain, low blood pressure, urinary retention, tremors, muscle twitching, increased body temperature, sweating, restlessness, sexual dysfunction, drowsiness, confusion, dizziness, anxiousness, apathy and irregular heart beat.

Atypical Antidepressants

• Atypical antidepressants usually have fewer side effects than SSRIs. Bupropion (Wellbutrin) is less likely to cause sexual dysfunction, but can trigger seizures in people with a history or risk of seizures. It can also cause weight loss, allergic reactions, dry mouth, headaches, heart palpitations and feelings of anxiousness, confusion, nervousness or agitation. Duloxetine (Cymbalta) should not be used by people with liver problems, narrow-angle glaucoma or risk of seizures. Mirtazapine (Remeron) can lower white blood cell count, cause allergic reactions, and liver or pancreas problems. Trazodone can cause priapism, which requires immediate treatment by a doctor. Venlafaxine (Effexor) and duloxetine can cause dizziness, nausea, vomiting, headache, irritability and nightmares if discontinued suddenly. General side effects for atypical antidepressants include changes in appetite, weight gain or loss, constipation, dizziness, drowsiness, dry mouth and sexual dysfunction.

Monoamine Oxidase Inhibitors

• Monoamine oxidase inhibitors (MAOIs) also were developed in the 1950s. They are now used only if nothing else works because they have more unpleasant side effects and potentially fatal food and drug interactions. These include Marplan, Nardil, Parnate and Emsam. MAOIs change the levels of neurotransmitters in the brain, including tyramine. This can cause potentially fatal high blood pressure when combined with certain foods that are high in tyramine such as aged cheeses and dairy products, pickled products, processed meats, chocolate and alcoholic beverages. Foods high in tryptophan also should be avoided as they could cause serotonin syndrome, which can be fatal. The general side effects of MAOIs include sleep problems, dry mouth, dizziness, appetite changes, weight gain, high blood pressure, problems with heart rate, sexual dysfunction, blurred vision, and numerous negative interactions with other drugs such as SSRIs, TCAs, phenethylamines and amphetamines.

Warning

• Antidepressants can cause physical dependencies, and other problems if discontinued too abruptly. Their use should be gradually discontinued under the care of a doctor. Antidepressants have been shown to increase the risk of suicide in people under the age of 18. They also can cause more severe side effects in older people, which may include bone loss, heart problems and negative cognitive effects such as dementia.