There are a variety of newer depression drugs, called atypical antidepressants, which target other neurotransmitters either alone or in addition to serotonin. Some of the brain chemicals they affect include norepinephrine and dopamine.
The side effects vary according to the specific drug. However, many of the atypical antidepressants can cause nausea, fatigue, weight gain, sleepiness, nervousness, dry mouth, and blurred vision.
Side effects of older depression drugs
Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) are older classes of antidepressants. Their side effects are more severe than those of the newer antidepressants, so they are only prescribed as a last resort after other treatments and medications have failed.
Once you’ve started taking antidepressants, stopping can be tough; many people have withdrawal symptoms that make it difficult to get off of the medication.
If you decide to stop taking antidepressants, it’s essential to consult a doctor and taper off slowly. If you stop abruptly, you may experience a number of unpleasant withdrawal symptoms such as crying spells, extreme restlessness, dizziness, fatigue, and aches and pains. These withdrawal symptoms are known as “antidepressant discontinuation syndrome." Antidepressant discontinuation syndrome is especially common when you stop taking Paxil or Zoloft. However, all medications for depression can cause withdrawal symptoms.
Antidepressant withdrawal symptoms
- Anxiety, agitation
- Depression, mood swings
- Flu-like symptoms
- Irritability and aggression
- Insomnia, nightmares
- Nausea and vomiting
- Dizziness, loss of coordination
- Stomach cramping and pain
- Electric shock sensations
- Tremor, muscle spasms
Depression and anxiety are also common symptoms when withdrawing from antidepressants. When depression is a withdrawal symptom, it’s often worse than the original depression that led to drug treatment in the first place. Unfortunately, many people mistake this withdrawal symptom for a return of their depressive illness and resume medication, creating a vicious circle.
In order to avoid antidepressant withdrawal symptoms, never stop your medication “cold turkey.” Instead, gradually taper your dose, allowing for at least 1-2 weeks between each dosage reduction. This tapering process may take up to several months, and should only be attempted under a doctor's supervision.
Antidepressants aren’t a cure. Medication may treat some symptoms of depression, but can’t change underlying contributions to depression in your life. Antidepressants won’t solve your problems if you’re depressed because of a dead-end job, a pessimistic outlook, or an unhealthy relationship. That’s where therapy and other lifestyle changes come in.
Studies show that therapy works just as well as antidepressants in treating depression, and it’s better at preventing relapse once treatment ends. While depression medication only helps as long as you’re taking it, the emotional insights and coping skills acquired during therapy can have a more lasting effect on depression. However, if your depression is so severe that you don't have the energy to pursue treatment, a brief trial of antidepressants may boost your mood to a level where you can focus on therapy.
In addition to therapy, other effective treatments for depression include exercise, meditation, relaxation techniques, stress management, support groups, and self-help steps. While these treatments require more time and effort initially, their advantage over depression medication is that they boost mood without any adverse effects
Depression recovery begins with positive daily lifestyle choices. If you cultivate supportive relationships, challenge negative thoughts, and nurture your physical health, you can help yourself, slowly but surely, overcome your depression.
Other depression treatment options
It sometimes takes time to find the depression treatment that’s right for you. Don’t be fooled into thinking that antidepressants are the best choice, just because they're sometimes the easiest choice. Alternate treatment options include:
- Psychotherapy. Therapy has proven to be extremely effective in the long-term treatment of depression. It can also provide you with the tools to help prevent depression from coming back. There are many types of therapy available. For help finding the right therapist see: Psychotherapy and Counseling
- Acupuncture. Acupuncture, the technique of using fine needles on specific points on the body, is increasingly being investigated as a treatment for depression, with some research studies showing promising results. If you decide to try acupuncture, make sure that you find a licensed qualified professional.
- Light therapy. Not all people with depression have a seasonal worsening of mood, but those who do may benefit from light therapy. Exposure to bright light from a light therapy box causes biochemical changes in the brain that can help control symptoms of seasonal affective disorder (SAD) and certain kinds of depression. As with any treatment, always consult a mental health professional before using.
Self-prescription risk
Self-prescribing antidepressant medication is extremely dangerous. It can even be fatal. At the very least you should consult a primary care doctor. Unfortunately, studies have shown that many primary care physicians lack the specialist training necessary to provide the highest quality mental health care. Therefore, the best case scenario is to confer with a psychiatrist or other mental health professional before taking antidepressants.
Source: American Psychosomatic Society
If you’re considering antidepressants as a treatment option, make sure you carefully consider all of your treatment options. The following questions may help you make your decision.
Questions to ask yourself and a mental health professional
- Is my depression severe enough to justify drug treatment?
- Is medication the best option for treating my depression?
- Am I willing to tolerate unwanted side effects?
- What non-drug treatments might help my depression?
- Do I have the time and motivation to pursue other treatments such as therapy and exercise?
- What self-help strategies might reduce my depression?
- If I decide to take medication, should I pursue therapy as well?
Questions to ask your doctor
- How much mental health care training have you had?
- Are there any medical conditions that could be causing my depression?
- What are the side effects and risks of the antidepressant you are recommending?
- Are there any foods or other substances I will need to avoid?
- How will this drug interact with other prescriptions I’m taking?
- How long will I have to take this medication?
- Will withdrawing from the drug be difficult?
- Will my depression return when I stop taking medication?
If you decide to take depression medication, it’s prudent to learn all you can about your prescription. The more you know about your antidepressant, the better equipped you’ll be to deal with side effects, avoid dangerous drug interactions, and minimize other safety concerns.
Some suggestions:
- See a psychiatrist, not a family physician. Your family physician might help you or your loved one first realize that you may need depression treatment. But although any medical doctor can prescribe medications, psychiatrists are doctors who specialize in mental health treatment. They are more likely to be familiar with the newest research on antidepressants and any safety concerns. Your health depends on your doctor's expertise, so it's important to choose the physician who is best qualified.
- Be patient. Finding the right drug and dosage is a trial and error process. It takes approximately 4 to 6 weeks for antidepressant medications to reach their full therapeutic effect. Many people try several medications before finding one that helps.
- Monitor side effects – Keep track of any physical and emotional changes you’re experiencing and talk to your doctor about them. Contact your doctor or therapist immediately if your depression gets worse or you experience an increase in suicidal thoughts.
- Don’t stop medication without talking to your doctor – Be sure to take your antidepressant according to the doctor's instructions. Don't skip or alter your dose, and don't stop taking your pills as soon as you begin to feel better. Stopping treatment prematurely is associated with high relapse rates. It can also cause serious withdrawal symptoms.
- Go to therapy – Medication can reduce the symptoms of depression, but it doesn’t treat the underlying problem. Psychotherapy can help you get to the root of your depression, change negative thinking patterns, and learn new ways of coping.
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