For better or worse, one of the primary treatments of clinical depression — antidepressants — come with a host of negative side effects. For some people, these side effects will be temporary and will go away on their own (or at least be reduced in intensity as your body acclimates to the medication). For others, the side effects may not go away and, in fact, may become intolerable.
Side effects are a normal part of taking virtually any prescription medication. Although the drugs are intended to treat the specific condition — in this case, depression — they also cause unwanted physical symptoms that are usually an annoyance.
You shouldn’t feel abnormal, awkward or self-conscious if you have any of these side effects. You should, however, talk to your doctor about them — especially if they make you feel worse or the side effects themselves are unbearable:
- Decreased sex drive or no sex drive at all
- Dry mouth — your mouth feels very dry and cannot produce the same amount of saliva as usual
- Mild to moderate nausea
- Insomnia — inability to get to sleep, or difficulty staying asleep
- Increased anxiousness or restlessness
- Daytime sleepiness or drowsiness
- Weight gain
- Constipation or diarrhea
- Increased sweating
Whatever you do, do not try and manage your medication — the dose, frequency or amount you take — on your own. You need to talk to your doctor before making any changes to your medication. Do not suddenly quit taking your medication, because it could cause intense withdrawal symptoms or even a return of your depression.
Keep in mind that some side effects can also be managed in conjunction with your doctor. There are remedies for dry mouth, for instance, and additional medications for other things (such as sexual dysfunction, a common side effect of many antidepressant medications).
Helping to Manage the Common Side Effects of Antidepressants
1. Decreased sex drive or no sex drive at all
Ask your doctor whether another medication is available that doesn’t have such strong sexual side effects, or if a lower dose may help with the problem. Talk to your doctor about other options, such as taking a medication for erectile dysfunction.
2. Dry mouth
Eat more water-laden snacks, like celery sticks, and consider chewing sugarless gum, or suck often on sugarless candy. The sugarless part is important, because otherwise the sugar of constant gum chewing or candy sucking can harm your teeth and cause future cavities. You can also consider increasing your daily water intake by drinking at least 8 to 10 glasses of water a day and cutting back on some of the caffeine-laden drinks, such as coffee, tea and alcohol. As a last resort, you can also try a specially formulated rinse for your mouth that may help, such as Biotene or Orazyme.
For the bad breath that often accompanies dry mouth, consider munching on these herbs: parsley, aniseed, fennel, rosemary and cayenne pepper (individually, not all together!). See this article for more details.
Helping to Manage the Common Side Effects of Antidepressants, Continued
Nausea is that queasiness you may feel in your stomach contemplating eating, or after you eat. You can combat these feelings by changing your eating schedule to eat more meals per day that are smaller. So instead of 3 big meals, you eat 6 smaller meals spread evenly throughout the day. This may be difficult for many people to incorporate into their lives, so you can also try this — eat some peppermint candy or chew some peppermint gum, because peppermint can help settle your stomach. And while not recommended for long-term use, antacids can usually help calm nausea.
4. Insomnia and sleep problems
The biggest thing that will help your sleep problems is to avoid the use of caffeine, cigarettes, and alcohol, especially after 4:00 pm, as caffeine can stay within your system for up to 8 hours. Ease into a sleep routine that’s different, by emphasizing low-stress and relaxing activities as you get closer to bedtime. Avoid watching television, especially TV shows that produce anxiety or stress in your (like the late-night news, or a tense drama). Consider reading before bedtime, an activity shown to help lower stress levels in people.
A part of a new daily routine may also be to switch when you exercise from the evening to the morning. While it may be more difficult to wake earlier to exercise, exercising in the evening or late afternoon releases endorphins and affects other neurotransmitter signals that tell your body to be more awake.
Avoid the use of sleep medications long-term, even if prescribed by a doctor. Sleep aids are meant for short-term use, and can become addictive with long-term, negative side effects. Talk to your doctor if you are unable to help rectify your sleep patterns on your own, because sleep is one of the most important components of your body’s needs.
5. Increased anxiousness or nervousness
Some people get a nervous energy from the antidepressant they’re taking. This is a side effect that resolves on its own for most people, but if it doesn’t for you, talk to your doctor about a lower dose, or changing the type of antidepressant you’re taking. Some people simply don’t tolerate certain antidepressants as well as others, and this can be a sign that this particular antidepressant is not right for you.
6. Daytime sleepiness or drowsiness
Like other side effects, you may find this side effect decreasing on its own as your body gets used to the medication. Some antidepressants have this effect more than others. Talk to your doctor to see if you can use this side effect to your advantage, by taking it at nighttime before you go to bed.
7. Weight gain
Weight gain is a common problem with a lot of psychiatric medications, including many antidepressants. While most people may only gain a few to 10 lbs while on an antidepressant, it can be troubling enough to cause its own stress. Weight gain is best addressed through a combination of trying to eat more healthy, reducing your overall calorie intake by at least 10 percent (in a typical 2,000 calorie diet, that would be 200 calories less per day), and engaging in regular — 3 to 4 times a week — exercise (even if it’s just committing to walking for 45 minutes a day). While exercise and eating less are far more difficult when one is depressed, these are the only proven methods for losing weight. Avoid fad or fast weight loss diets, and consider joining a gym or weight loss support group to give you the extra emotional support to help you with this.
8. Constipation or diarrhea
Constipation can be helped by eating more insoluble fiber. Insoluble fiber is the indigestible part of the plant — like strawberry seeds, apple and bean skins, the bran shell on brown rice and wheat grains. People who have irritable bowel syndrome (IBS) may find that too much insoluble fiber worsens diarrhea. If you have IBS, you may want to opt for more soluble fiber.
So you can try to eat more bran and other whole-grain cereals. For instance, switch to a higher-fiber bread for lunch instead of white or a roll. Enjoy more high-fiber fruits and vegetables, such as apples, prunes, beans, and broccoli. Consider taking a fiber supplement (available in a wide range of forms, even tasteless additives to a glass of water) if you can’t fit more fiber into your diet. And drink plenty of fluids throughout the day — especially water.
For diarrhea , avoid spicy and high-fat foods until you feel better. The same things apply about eating more soluble fiber, because fiber regulates our digestive systems for both conditions. Soluble fiber is soft stuff — the insides of beans, peas, lentils, mangoes, apples, peaches, figs, pineapple, pears, etc. It also acts to slow down food as it passes through your intestines, which can help prevent diarrhea.
Headaches will often decrease or go away altogether as your body adjusts to the antidepressant. If they don’t, ask your doctor about which over-the-counter pain relief medications are best to take for your headache in conjunction with your antidepressant.
10. Increased sweating
Some people find that they sweat more when on some types of antidepressants. Reduce sweating by wearing more loose fitting clothing and minimizing physical activity, especially during the warmest parts of the day.
Dizziness can sometimes occur when taking certain antidepressants. Try to reduce dizziness by getting up more slowly when you are sitting or lying down.
Serious side effects
You shouldn’t try and manage all side effects, because some side effects are serious and may indicate a more immediate health problem. Talk to your doctor right away if you experience any of the following:
- Chest pain.
- Shortness of breath, trouble swallowing, swollen lips, hives, or other signs of a serious allergic reaction.
- Suicidal thoughts or feelings, or any signs of suicide, such as talking or writing about death, giving away belongings, or withdrawing from family and friends.
- Manic behavior, such as having very high energy, sleeping less than normal, being impulsive, or being grouchy or restless.
Grohol, J. (2011). Managing the Painful Side Effects of Antidepressants. Psych Central. Retrieved on March 11, 2014, from http://psychcentral.com/lib/managing-the-painful-side-effects-of-antidepressants/0008537
Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
Published on PsychCentral.com. All rights reserved.