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If you have been diagnosed with depression your doctor may have started you on an antidepressant to help relieve your symptoms. 

There are several different types of antidepressants available. 

The main ones are:


  • Tricyclics
  • SSRIs (Selective Serotonin Reuptake Inhibitors)
  • SNRIs (Serotonin and Noradrenaline Reuptake Inhibitors)
  • MAOIs (Monoamine Oxidase Inhibitors)


These medicines may also be used to treat some other conditions such as anxiety, panic disorder, obsessive-compulsive disorder, eating disorders and some forms of pain.


How should antidepressants be taken?


  • Take them every day – if you don’t take them they won’t work!
  • Stay in touch with your doctor in the first few weeks.  Your doctor will want to know if you get increased feelings of restlessness or agitation.
  • Persevere – the most common reason for people not getting better is stopping treatment too early. 
  • Do not stop taking them without discussing it with your doctor.  At the end of the treatment course, you should gradually reduce the dose.  Your doctor should advise you on this.


How do they work?


It is thought that antidepressants work by altering the balance of some chemicals in the brain called neurotransmitters, in particular serotonin and noradrenaline.



How long will they take to work


When starting treatment with an antidepressant, it is usually 2 to 4 weeks before a full response is seen.  It is therefore worth waiting up to 4 weeks before deciding whether or not the treatment is helping.  In older people it may take up to 6 weeks before the full response is seen.


How well do they work?


The symptoms of depression will improve in about 6-7 out of 10 people who take an antidepressant.  However some people may improve without treatment.  In about 3 out of 10 people, symptoms improve with placebo or ‘dummy’ tablets.  In other words they don’t work in everybody, but you are approximately twice as likely to improve if you take antidepressants compared to no treatment.



Do they have side effects?


All medicines have possible side effects; the important thing to remember is not everybody gets them.  The common side effects you might experience with the different types of antidepressants are listed below.




Fairly common side effects include a dry mouth, drowsiness, constipation, and slight hesitation in passing urine, slight blurring of vision and sweating.  They may cause confusion, sexual problems, weight gain, faintness through low blood pressure and falls (particularly in older people.)  Tricyclics are dangerous in overdose.




The most common side effects include feeling sick, vomiting, diarrhoea and indigestion.  Sexual problems may sometimes occur. 


Some people develop a feeling of restlessness or anxiety when they first start treatment.  There have been some case reports that claim a link between taking an SSRI and feeling suicidal.  There is not convincing evidence of such a link.  However if you become anxious or agitated or have any suicidal thoughts, particularly in the early stages of treatment, or after an increase in dose, you should see your doctor as soon as possible.




Side effects are similar to SSRIs.  Venlafaxine may cause constipation.  It is not recommended for people with heart problems or high blood pressure.




Individuals taking MAOIs may have to be careful about eating certain foods containing a substance called tyramine as this may cause a dangerously high blood pressure.  This type of antidepressant is rarely prescribed nowadays.  If you are prescribed an MAOI your doctor will give you a list of foods to avoid.



You should find a list of possible side effects on the leaflet that comes in the medicine packet.  With all antidepressants it is worth keeping on with treatment if side effects are mild at first.  They may ease off after a week or so as the body becomes used to the medication.  However if a side effect persists or is troublesome you should tell your doctor.  It may be that a different treatment would suit you better.


Are they addictive?


Antidepressants are not thought to be addictive in the way that tranquillisers are.  You do not need to keep increasing the dose to get the same effect, and you are unlikely to crave them if you stop taking them.


Having said that some people do find that they get withdrawal symptoms when they stop taking them.  To prevent this it is recommended that the dose be reduced very slowly over about four weeks (or longer if withdrawal symptoms emerge) before it is stopped completely.  Withdrawal symptoms seem to be more common when stopping paroxetine and venlafaxine.


Withdrawal symptoms that may occur include: flu-like symptoms, dizziness, anxiety and agitation, sleep disturbances, feeling sick, abdominal cramps, diarrhoea, pins and needles and mood swings.



When should I stop taking them?


Antidepressants should usually be continued for six months after the symptoms have eased.  If you stop the medication too soon, the symptoms are more likely to come back. 


If you have had two or more attacks of depression, treatment should be continued for at least two years.



Can I drink alcohol while taking them?


It is better not to drink alcohol.  Alcohol on it’s own can make your depression worse, but it can also make you slow and drowsy if you are taking antidepressants.  This may lead to problems with concentration and the performance of skilled tasks such as driving.



Do antidepressants affect sleep?


Depression itself can have an impact on sleep.  Antidepressants may help with this as they begin to work.  Tricyclics in particular may cause drowsiness and therefore may be helpful for people that are having problems sleeping, if taken at night.  Having said that, SSRIs can sometimes cause problems with sleep and for this reason may be better taken in the morning.



Changing Minds, Mobile X3 Park Campus, University of Northampton, Boughton Green Road, Northampton, NN2 6AL