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Depression - Side Effects of Depression Medications

Before starting a new medication, ask your health professional to tell you about any side effects you may experience. Antidepressants may cause mild and, usually, temporary side effects (sometimes referred to as adverse effects) in some people. Typically these are annoying, but not serious.

However, any unusual reactions or side effects, or those that interfere with functioning, should be reported to your health professional immediately.

The most common side effects of tricyclic antidepressants, and ways to deal with them, are:

Dry mouth: it is helpful to drink sips of water; chew sugarless gum; clean teeth daily

Constipation: bran cereals, prunes, fruit, and vegetables should be in the diet

Bladder problems: emptying the bladder may be trouble-some, and the urine stream may not be as b as usual; the doctor should be notified if there is marked difficulty or pain

Sexual problems: sexual functioning may change; if worrisome, it should be discussed with the doctor

Blurred vision: this will pass soon and will not usually necessitate new glasses

Dizziness: rising from the bed or chair slowly is helpful

Drowsiness as a daytime problem: this usually passes soon. A person feeling drowsy or sedated should not drive or operate heavy equipment. The more sedating antidepressants are generally taken at bedtime to help sleep and minimize daytime drowsiness.

The most common side effects of the newer antidepressants (SSRIs and others) are:

Headache: this will usually go away

Nausea: this is also temporary, but even when it occurs, it is transient after each dose

Nervousness and insomnia (trouble falling asleep or waking often during the night): these may occur during the first few weeks; dosage reductions or time will usually resolve them

Agitation (feeling jittery): if this happens for the first time after the drug is taken and is more than transient, the doctor should be notified

Sexual problems: the doctor should be consulted if the problem is persistent or worrisome. Although depression itself can lower libido and impair sexual performance, it has been clearly established that SSRIs and other bly serotonergic antidepressants (e.g., the tricyclic antidepressant clomipramine) provoke new, dose-dependant sexual dysfunction independent of their therapeutic activity in both men and women.

These side effects can affect more than half of adults taking SSRIs. In men, common problems include reduced sexual drive, erectile dysfunction, and delayed ejaculation.

In some cases of sexual dysfunction, the symptoms improve with the development of tolerance or lowering of the dose of medication; drug "holidays" in anticipation of sexual activity have proved to be successful for some patients taking shorter-acting SSRIs but are not feasible in the case of fluoxetine (Prozac).

Data describing differences among the SSRIs are limited, and there are no data showing a clinical benefit with respect to sexual dysfunction as a result of switching medications within this class. If an antidepressant must be changed, one from a different class should be substituted; bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), and venlafaxine (Effexor) appear to be good choices on the basis of these side effects.

Guided by a limited number of studies, some clinicians treating men with anti- depressant-associated sexual dysfunction report improvement with the addition of bupropion (Wellbutrin), buspirone (BuSpar), or sildenafil (Viagra)40 to ongoing treatment. Be sure to discuss the various options with your health professional, as there may be other interventions that can help.

Treatment Options Continued;

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