Antidepressants

This section gives information about antidepressants. Antidepressants can help with different mental health problems, including low mood, depression, and anxiety.

Overview

  • Antidepressant medications are used to treat depression and other mood disorders.
  • There are different types of antidepressants. You may need to try different ones before finding one that works for you.
  • You may get side effects from antidepressants. Talk to your doctor if you get side effects that cause you problems.
  • You may get withdrawal symptoms when you stop taking antidepressant medication. Talk to your doctor before you stop taking them, even if you feel better. Your doctor may take you off your medication slowly if you have been taking them for a long time.
  • Antidepressant medication can affect other medications. Tell your doctor if you take any other medication.

About

What are antidepressants?

Your doctor, or psychiatrist, may offer you antidepressants if you have very low mood or symptoms of depression. They can also help if you have other mental health problems, including anxiety.

Scientists aren’t sure how antidepressants work. But they think that they may work by increasing levels of certain chemicals in your brain that help improve your mood and emotions.

Antidepressants should start to work within 2-3 weeks. There is no set time for how long you should take antidepressants. Your doctor may ask you to take your antidepressants for 6 months after your symptoms are gone. This can help stop your symptoms coming back. Your doctor will work out how much you should take, and for how long.

Are there different types of antidepressant?

All antidepressants work in different ways. One type of antidepressant may suit you more than another. Here, we give an overview of the different types.

Selective serotonin re-uptake inhibitors (SSRIs)

The National Institute for Health and Clinical Excellence (NICE) suggests that SSRIs have fewer side effects than the other types of antidepressants. All the following medications treat low mood and depression. Some may also treat other conditions, including anxiety, bulimia, panic disorder, and obsessive-compulsive disorder.

Medication name Brand name
Citalopram Cipramil
Escitalopram Cipralex
Fluoxetine Prozac
Fluvoxamine Faverin
Paroxetine Seroxat
Sertraline Lustral

 

Serotonin-noradrenaline reuptake inhibitors (SNRIs)

SNRIs are similar to SSRIs. They are also used to treat depression.

Medication name Brand name
Duloxetine Cymbalta, Yentreve, Dutor, Depalta
Venlafaxine Efexor, Venlalic, Sunveniz, Venladex, ViePax
Reboxetine Edronax

Tricyclic antidepressants (TCAs)

TCA’s can treat depression, obsessive compulsive disorder and bipolar disorder. TCA’s can take 2 to 4 weeks to work. These are older medicines, and generally have more side effects than other antidepressants.

Below is a list of TCAs.

  • Amitriptyline,
  • Clomipramine,
  • Dosulepin or Dothiepin. These can also be branded as Prothiaden or Dothapax,
  • Doxepine. This can also be branded as Xepin,
  • Imipramine,
  • Lofepramine,
  • Nortriptyline,
  • Mianserin, and
  • Trimipramine.

Mono-amine oxidase inhibitors (MAOIs)

MAOIs are an older antidepressant. These are not prescribed as much. Your doctor should monitor you if you take these. You cannot eat certain foods if you take these. Your doctor should give you more information if they prescribe these for you.

  • socarboxazid,
  • Phenelzine. This is also branded as Nardil,
  • Tranylcypromine, and
  • Moclobemide. This is also branded as Manerix.

Other medication

Below is a list of other medication which can treat depression.

  • Mirtazapine. This is also branded as Zispin, and
  • Trazodone. This is also branded as Molipaxin.

SSRIs, SNRIs and TCAs can all be prescribed for pain. TCAs can be used to treat chronic nerve pain. Nerve pain is called neuropathic pain. SSRIs and SNRIs can be used to treat non-neuropathic chronic pain.

Side effects and other issues

Are there any side effects?

Different antidepressants will have different side effects. The newer antidepressants should have fewer side effects than the older ones. People can have different reactions to medication.

You should get a patient information leaflet with your medication. This leaflet will tell you all the possible side effects you might get. The table below tells you about the common side effects.

Antidepressant Common Occasional
SSRIs Dizziness, feeling irritable, problems sleeping, vivid dreams, flu-like symptoms (for example nausea, headaches, chills), feeling tearful, 'shock-like' feelings Memory and concentration problems, movement disorders.
SNRIs Tiredness, dizziness, light-headedness, headache, sleeplessness, nightmares, nausea, diarrhoea, ringing in the ears, tingling, 'shock-like' feelings. Memory and concentration problems, movement disorders.
Tricyclic Antidepressants Problems sleeping, dreaming a lot, flu-like symptoms (for example nausea, muscle pain, headaches, excessive sweating, chills). Movement problems, mania, unusual heart pace.
MAOIs Feeling irritable, anxiety, problems sleeping, vivid dreams, slowed speech and a lack of muscle co-ordination. Hallucinations, delusions.

We describe symptoms of mania in our bipolar factsheet. You can find more information on ‘Bipolar disorder’ by clicking here.

Do antidepressants affect other medication?

This section is just a summary. You should tell your doctor or pharmacist about any medicines you take before you start or stop other medications. This is because different medications taken together can affect each other. This includes over the counter medication or herbal and complementary medicines. Such as:

  • ibuprofen,
  • other antidepressants,
  • St John’s Wort, and
  • anaesthetics.

You should also talk to your doctor about any illegal drugs you may be taking. Taking certain illegal drugs whilst on antidepressants can cause unpredictable and unpleasant effects. You may be worried about talking to your doctor about your drug use. But doctors are used to talking to people about drug use. And they will keep the information confidential.

Read through the patient information leaflet provided with your medicine before you start taking it. You can also find medicine leaflets online, on the electronic Medicines Compendium at www.medicines.org.uk.

Do any foods affect antidepressants?

There are some foods that contain an amino acid called Tyramine. Tyramine can build up in your body if you eat it when you are taking MAOIs. Examples of foods that contain this amino acid are:

  • cheese,
  • pickled or salted meats or fish,
  • processed meat like pate and salami,
  • dried soups,
  • slimming products like Slimfast, and
  • Oxo, Marmite, or Bovril.

If you are taking this medication, ask your doctor about any foods that you should not eat.

Does alcohol affect my antidepressants?

Drinking alcohol while taking antidepressants is not advised because alcohol can make depression worse. It can also increase the side effects of some antidepressants, like drowsiness, dizziness, and co-ordination problems.

To avoid alcohol-related harm, the NHS recommends that you should drink no more than 14 units of alcohol a week. It's best to spread this evenly over three or more days.

You should not drink certain wines or beers if you are taking MAOIs. You should ask your pharmacist or doctor for more information.

Can I drive when taking antidepressants?

Some antidepressants can affect your ability to drive. You may feel drowsy from your medication, which can affect your reaction time. If your antidepressants make you drowsy you should not drive.

You should tell the DVLA if you are taking medication that may affect your driving. You should also tell them if you have a medical condition that could affect your driving.

You can find out more information about ‘Driving and mental illness’ by clicking here.

Further considerations

What else should I consider before taking antidepressants?

Sex

Taking antidepressants may affect your sex life. Antidepressants can make you feel tired and can affect your hormones.

Side effects include:

  • lower sex drive,
  • problems with getting an erection, and
  • difficulty having an orgasm.

If you are having these problems, talk to your doctor. You might be able to change medication, or the amount you take.

Pregnancy

You can take some antidepressants if you are pregnant, but you should talk to your doctor. You may want to stay on antidepressants during your pregnancy, if you think your symptoms will come back. Some antidepressants may be better for you during pregnancy than others.

If you are pregnant, some antidepressants can affect the baby. Some possible effects can be:

  • low birth weight,
  • heart disease, and
  • pulmonary hypertension. This is high blood pressure in the blood vessels between your lungs and heart.

Talk to your doctor if you are pregnant, or plan on getting pregnant.

Breast feeding

Small amounts of antidepressants can pass into your breast milk. Talk to your doctor or midwife about the risks and benefits of breastfeeding. Some antidepressants are better than others if you are breastfeeding, and your doctor can tell you about this.

Useful contacts

Bristol Tranquilliser Project
Bristol Tranquilliser Project provides help to people who are having problems with psychotropic medication, such as benzodiazepines, sleeping tablets, and antidepressants. Their helpline is available to those living in England, Wales, Scotland and Northern Ireland.

Telephone: 0117 950 0020 (10am - 3.30pm Monday – Thursday).
Address: Suite 5A, Westbury Court, Church Road, Westbury-on-Trym, Bristol BS9 3EF
Website: www.btpinfo.org.uk

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