The Side Effects of Antidepressants

 In the last several entries of this blog, I’ve been extolling the virtues of antidepressants, which have been proven effective in treating various mood and anxiety disorders. Antidepressants are sometimes also prescribed for a wide assortment of other conditions and purposes, such as for pain syndromes, insomnia, smoking cessation, hot flashes, bed wetting, and itching.
The testing that is performed in humans during clinical trials confirms whether medications are doing the positive things they are supposed to be doing. These clinical investigations also help predict the negative side effects that future patients may experience. “Adverse events” are the undesired things that researchers keep track of while medications are being tested in people. Adverse events can be mild or severe, and they can be common or rare.
So, like all medications for all disorders, antidepressants have some desired actions and some potentially undesirable actions. Side effects are the actions we don’t like, although occasionally what is good for one person may be bad for another. Some antidepressants, for example, increase appetite and cause weight gain, which may be very beneficial for some patients, but a huge problem for others. Sedation from some antidepressants can help with insomnia, but also can lead to undesired sleepiness during the day for some people.
The side effects of antidepressants may be minor and easy to tolerate, or they may be so severe that people stop taking the medications. Many people experience no side effects with antidepressants, but, very rarely, side effects can be fatal. Usually side effects are considered to be direct effects of the drugs, but people sometimes have allergic reactions (mild or severe) to these medications that are really caused when the body’s immune system reacts abnormally to the presence of the drug.
Some antidepressant side effects are relatively common, while others almost never occur. Some of the side effects are similar for most antidepressants or for major classes of the drugs, while others occur only with individual medications. When people are taking two or more medications, drug-drug interactions can sometimes cause problems, even when the drugs are being taken for entirely different conditions.
The list of possible antidepressant side effects is extremely long. Relatively common problems with the tricyclic antidepressants (TCA), for example, include dry mouth, blurred vision, constipation, and sedation.
More common problems with the selective serotonin reuptake inhibitors (SSRIs­) such as Prozac include insomnia, gastrointestinal symptoms such as nausea, and sexual dysfunction problems such as decreased arousal and difficulty achieving orgasm.
If you are taking an antidepressant, make sure you know about the common side effects for that particular drug and what symptoms you should ask your doctor about if they should appear. Be sure to talk to your doctor or other health care providers about any concerns you have about your medications in general, and make sure that anyone prescribing medications for you knows all the other medications you are taking.
And please remember: If you are having difficulty with one antidepressant, don’t give up on all of them. There are many different choices and so it is likely that one will help you without causing bothersome side effects.

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