Antidepressants
Antidepressants are medications used to treat depression. In some cases, health care providers may prescribe antidepressants to treat other health conditions such as anxiety, pain, and insomnia.
Commonly prescribed types of antidepressants include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and norepinephrine-dopamine reuptake inhibitors (NDRIs).
Common Side Effects
These medications are commonly prescribed because they improve symptoms related to a broad group of depressive and anxiety disorders and are associated with fewer side effects than older types of antidepressants. Although older antidepressant medications, such as tricyclics and monoamine oxidase inhibitors (MAOIs), are associated with more side effects, they may be the best option for some people.
Antidepressant medications take time to work—usually 4 to 8 weeks—and symptoms such as problems with sleep, appetite, energy, or concentration sometimes improve before mood lifts. It is important for people to follow their health care provider’s directions and take the medication for the recommended amount of time before deciding whether it works.
Common side effects of SSRIs and other antidepressants may include upset stomach, headache, or sexual dysfunction. The side effects are generally mild and tend to improve over time. People who are sensitive to the side effects of these medications sometimes benefit from starting with a low dose, increasing the daily dose very slowly, and adjusting when they take the medication (for example, at bedtime or with food).
Treatment-Resistant Depression
Esketamine is a newer FDA-approved medication for treatment-resistant depression, which may be diagnosed when a person’s symptoms have not improved after trying at least two antidepressant therapies. Esketamine is delivered as a nasal spray in a health care provider’s office, a clinic, or a hospital. It often acts rapidly—typically within a couple of hours—to relieve depression symptoms. People usually continue to take an oral antidepressant to maintain the improvement in symptoms.
Medications and Supplements
Combining antidepressants with medications or supplements that also act on the serotonin system, such as “triptan” medications (often used to treat migraine headaches) and St. John’s Wort (a dietary supplement), can cause a rare but life-threatening illness called serotonin syndrome. Symptoms of serotonin syndrome include agitation, muscle twitches, hallucinations (seeing or hearing things others do not see or hear), high temperature, and unusual blood pressure changes. For most people, the risk of such extreme reactions is low. It is important for health care providers to consider all possible interactions and use extra care in prescribing and monitoring medication combinations that carry above-average risk.
Suicide Risk
Please note: In some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting the medication or when the dose is changed. People of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment.
If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline at 988 or chat at 988lifeline.org. In life-threatening situations, call 911.