Antidepressants: Get tips to cope with side effects
by Mayo Clinic Staff
Dec. 9, 2008
Introduction
Antidepressants often cause unpleasant side effects. Many of these side effects last only a few weeks and then go away on their own. Even if a side effect doesn't go away, you can learn ways to manage it. Don't stop taking your antidepressant or reduce the dosage without first talking to your doctor or mental health provider. Suddenly stopping can cause withdrawal-like health problems. Always tell your health care provider about your side effects, because some can be serious.
Coping strategies for the most common side effects of antidepressants:
Nausea
Nausea typically begins within a week of starting an antidepressant. It often goes away within a few weeks, when your body adjusts to the medication.
Coping strategies
* Take antidepressants with food.
* Eat smaller, more frequent meals.
* Suck on sugarless hard candy.
* Drink plenty of fluids, such as unsweetened fruit juice, cool water or ginger ale that's lost its carbonation.
* Try an antacid or bismuth subsalicylate (Pepto-Bismol).
* Talk to your doctor about a dosage change or a slow-release form of the medication.
Increased appetite, weight gain
You may gain weight because of fluid retention, lack of physical activity or development of a better appetite when your depression symptoms decrease. Bupropion (Wellbutrin) and certain selective serotonin reuptake inhibitors (SSRIs) are generally less likely to cause a lot of weight gain.
Coping strategies
* Eat healthy foods, such as plenty of fruits, vegetables and whole grains.
* Cut back on sweets, sugary drinks and fast foods.
* Try to exercise at least 30 minutes a day.
* Seek advice from a nutritionist or dietitian.
* Talk to your doctor about switching medications.
Sexual side effects
Sexual side effects include decreased desire (libido), erectile dysfunction, delayed ejaculation and decreased orgasm. These can last throughout treatment. Selective serotonin reuptake inhibitors (SSRIs) are more likely to cause sexual side effects, particularly delayed orgasm or inability to achieve orgasm (anorgasmia). Tricyclic antidepressants (TCAs) are more likely to cause erectile dysfunction.
Coping strategies
* Talk to your doctor about changing your dose.
* Consider a medication that requires only a once-a-day dose, and schedule sexual activity before taking that dose.
* Talk to your doctor about adding or switching to an antidepressant that may counteract these effects, such as bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL).
* Talk to your doctor about taking a medication intended to directly treat sexual dysfunction.
* Talk to your doctor about a "drug holiday" — stopping medication for a day or so each week.
Fatigue, drowsiness
Fatigue and drowsiness are common, especially during early weeks of treatment with antidepressants.
Coping strategies
* Take a brief nap during the day.
* Get some mild exercise, such as walking.
* Avoid driving or operating machinery until the fatigue passes.
* Take the medication one to two hours before bedtime.
Insomnia
Insomnia can result because some antidepressants give you an energy boost. While that may sound appealing, it can also make it difficult to get to sleep or stay asleep — and you may be tired during the day.
Coping strategies
* Take medication in the morning.
* Avoid caffeinated food and drinks.
* Get regular exercise at least four or five hours before bedtime.
* Develop a relaxing bedtime routine.
* Talk to your doctor about temporarily taking a sedating medication at bedtime.
Dry mouth
Dry mouth is a common side effect of antidepressants, such as tricyclic antidepressants (TCAs), that have anticholinergic effects — they block the action of the neurotransmitter acetylcholine. That, in turn, disrupts functioning of the digestive tract and other organ systems, reducing mucus and saliva secretions.
Coping strategies
* Sip water regularly.
* Suck on ice chips.
* Chew sugarless gum.
* Suck on sugarless hard candy.
* Breathe through your nose, not your mouth.
* Brush your teeth twice a day.
* Visit your dentist regularly to help prevent tooth decay.
* Talk to your doctor about saliva substitutes.
Blurred vision
Blurred vision is a common side effect, but it usually goes away on its own within a couple of weeks. It's usually associated with antidepressants, such as tricyclic antidepressants (TCAs), that block the neurotransmitter acetylcholine, which can dry out your eyes and cause blurriness.
Coping strategies
* Get an eye exam to rule out other causes of your eye problems.
* Talk to your doctor about using special eyedrops to relieve dryness.
* Talk to your doctor about a dose adjustment.
Constipation
Constipation is often associated with tricyclic antidepressants (TCAs) because they block the neurotransmitter acetylcholine. That, in turn, disrupts normal functioning of the digestive tract and other organ systems.
Coping strategies
* Drink six to eight glasses of water daily.
* Eat high-fiber foods, such as fresh fruits and vegetables, brans and whole grains.
* Get regular exercise.
* Take fiber supplements.
* Consider taking stool softeners if other measures don't work.
Dizziness
Dizziness is more common with tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). These medications can cause low blood pressure, resulting in dizziness. This side effect is more common in older people.
Coping strategies
* Rise slowly from sitting or standing positions.
* Use handrails, canes or other sturdy items for support.
* Avoid driving or operating machinery.
* Avoid caffeine, tobacco and alcohol.
* Drink plenty of fluids.
* Take medication at bedtime.
Agitation, restlessness, anxiety
Agitation, restlessness and anxiety can result from the stimulating effect that some antidepressants have. Although having more energy may sound appealing, it may mean you can't relax or sit still even if you want to. Be alert for racing or impulsive thoughts along with high energy. If these develop, talk to your doctor right away because they may be signs of mood instability or another serious disorder.
Coping strategies
* Get vigorous exercise, such as jogging, biking or aerobics.
* Practice deep-breathing exercises and muscle relaxation.
* Consult your doctor about temporarily taking a relaxing medication.
by Mayo Clinic Staff
Dec. 9, 2008
Introduction
Antidepressants often cause unpleasant side effects. Many of these side effects last only a few weeks and then go away on their own. Even if a side effect doesn't go away, you can learn ways to manage it. Don't stop taking your antidepressant or reduce the dosage without first talking to your doctor or mental health provider. Suddenly stopping can cause withdrawal-like health problems. Always tell your health care provider about your side effects, because some can be serious.
Coping strategies for the most common side effects of antidepressants:
Nausea
Nausea typically begins within a week of starting an antidepressant. It often goes away within a few weeks, when your body adjusts to the medication.
Coping strategies
* Take antidepressants with food.
* Eat smaller, more frequent meals.
* Suck on sugarless hard candy.
* Drink plenty of fluids, such as unsweetened fruit juice, cool water or ginger ale that's lost its carbonation.
* Try an antacid or bismuth subsalicylate (Pepto-Bismol).
* Talk to your doctor about a dosage change or a slow-release form of the medication.
Increased appetite, weight gain
You may gain weight because of fluid retention, lack of physical activity or development of a better appetite when your depression symptoms decrease. Bupropion (Wellbutrin) and certain selective serotonin reuptake inhibitors (SSRIs) are generally less likely to cause a lot of weight gain.
Coping strategies
* Eat healthy foods, such as plenty of fruits, vegetables and whole grains.
* Cut back on sweets, sugary drinks and fast foods.
* Try to exercise at least 30 minutes a day.
* Seek advice from a nutritionist or dietitian.
* Talk to your doctor about switching medications.
Sexual side effects
Sexual side effects include decreased desire (libido), erectile dysfunction, delayed ejaculation and decreased orgasm. These can last throughout treatment. Selective serotonin reuptake inhibitors (SSRIs) are more likely to cause sexual side effects, particularly delayed orgasm or inability to achieve orgasm (anorgasmia). Tricyclic antidepressants (TCAs) are more likely to cause erectile dysfunction.
Coping strategies
* Talk to your doctor about changing your dose.
* Consider a medication that requires only a once-a-day dose, and schedule sexual activity before taking that dose.
* Talk to your doctor about adding or switching to an antidepressant that may counteract these effects, such as bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL).
* Talk to your doctor about taking a medication intended to directly treat sexual dysfunction.
* Talk to your doctor about a "drug holiday" — stopping medication for a day or so each week.
Fatigue, drowsiness
Fatigue and drowsiness are common, especially during early weeks of treatment with antidepressants.
Coping strategies
* Take a brief nap during the day.
* Get some mild exercise, such as walking.
* Avoid driving or operating machinery until the fatigue passes.
* Take the medication one to two hours before bedtime.
Insomnia
Insomnia can result because some antidepressants give you an energy boost. While that may sound appealing, it can also make it difficult to get to sleep or stay asleep — and you may be tired during the day.
Coping strategies
* Take medication in the morning.
* Avoid caffeinated food and drinks.
* Get regular exercise at least four or five hours before bedtime.
* Develop a relaxing bedtime routine.
* Talk to your doctor about temporarily taking a sedating medication at bedtime.
Dry mouth
Dry mouth is a common side effect of antidepressants, such as tricyclic antidepressants (TCAs), that have anticholinergic effects — they block the action of the neurotransmitter acetylcholine. That, in turn, disrupts functioning of the digestive tract and other organ systems, reducing mucus and saliva secretions.
Coping strategies
* Sip water regularly.
* Suck on ice chips.
* Chew sugarless gum.
* Suck on sugarless hard candy.
* Breathe through your nose, not your mouth.
* Brush your teeth twice a day.
* Visit your dentist regularly to help prevent tooth decay.
* Talk to your doctor about saliva substitutes.
Blurred vision
Blurred vision is a common side effect, but it usually goes away on its own within a couple of weeks. It's usually associated with antidepressants, such as tricyclic antidepressants (TCAs), that block the neurotransmitter acetylcholine, which can dry out your eyes and cause blurriness.
Coping strategies
* Get an eye exam to rule out other causes of your eye problems.
* Talk to your doctor about using special eyedrops to relieve dryness.
* Talk to your doctor about a dose adjustment.
Constipation
Constipation is often associated with tricyclic antidepressants (TCAs) because they block the neurotransmitter acetylcholine. That, in turn, disrupts normal functioning of the digestive tract and other organ systems.
Coping strategies
* Drink six to eight glasses of water daily.
* Eat high-fiber foods, such as fresh fruits and vegetables, brans and whole grains.
* Get regular exercise.
* Take fiber supplements.
* Consider taking stool softeners if other measures don't work.
Dizziness
Dizziness is more common with tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). These medications can cause low blood pressure, resulting in dizziness. This side effect is more common in older people.
Coping strategies
* Rise slowly from sitting or standing positions.
* Use handrails, canes or other sturdy items for support.
* Avoid driving or operating machinery.
* Avoid caffeine, tobacco and alcohol.
* Drink plenty of fluids.
* Take medication at bedtime.
Agitation, restlessness, anxiety
Agitation, restlessness and anxiety can result from the stimulating effect that some antidepressants have. Although having more energy may sound appealing, it may mean you can't relax or sit still even if you want to. Be alert for racing or impulsive thoughts along with high energy. If these develop, talk to your doctor right away because they may be signs of mood instability or another serious disorder.
Coping strategies
* Get vigorous exercise, such as jogging, biking or aerobics.
* Practice deep-breathing exercises and muscle relaxation.
* Consult your doctor about temporarily taking a relaxing medication.
