No matter what medications you take, always tell your doctor about uncomfortable or worrisome side effects immediately. You and your doctor can often alleviate side effects with a few simple steps. Here are some suggestions for dealing with common side effects of antidepressants:
Dry mouth. Drink a lot of water, chew sugarless gum, and brush your teeth frequently.
Constipation. Eat whole grains, bran cereal, prunes, and hearty servings of fruits and vegetables. Drink plenty of water.
Trouble urinating. If you have difficulty starting urination, your doctor may be able to adjust your medication to relieve this problem.
Dizziness. Sudden changes in position can lead to a sharp drop in blood pressure that causes dizziness. To counter this effect, rise slowly from a chair or when getting out of bed. Also, drink plenty of fluids.
Daytime drowsiness. This problem usually occurs at the beginning of treatment and may not last long. In some cases, it may help to take medication at bedtime, but ask your doctor about this first. If you feel drowsy, don’t drive or use heavy equipment.
Trouble sleeping. Sleep often improves after a few weeks, but sometimes a mild sleep aid or a switch to another medication is necessary.
Nausea. Often, nausea disappears within a few weeks. It may help to take the drug shortly after a substantial meal.
Agitation. You might feel uncomfortably nervous or restless after you start taking a drug. Jittery feelings may pass within a few weeks. But in relatively rare cases, agitation will persist; sometimes it’s an early symptom of worsening depression or mania.
Headache. Headaches may come and go. Some persist, but they usually disappear within a few weeks.
Sexual difficulties. Sometimes sexual problems are transient or not related to the drug. Talk with your doctor about sexual problems that don’t pass soon. (See Sexuality and SSRIs.)
If side effects continue to bother you, your doctor may change your dosage, shift the time of day that you take the medication, or split the dosage into smaller amounts to be taken over the course of the day. Or he or she may recommend combining the drug with another one, switching to a different drug, or replacing drugs with therapy or other forms of treatment.
Call your doctor right away if you feel more depressed instead of less or if you feel worse for any reason.
Sexuality and SSRIs
One drawback to the popular antidepressants known as selective serotonin reuptake inhibitors or SSRIs is that they frequently dampen sexual response. One study suggested that as many as half of all people taking these medications may experience some sexual problems. In addition to reducing interest in sex, SSRIs can make it difficult to become aroused, sustain arousal, and reach orgasm. Some people taking SSRIs aren’t able to have an orgasm at all. If you experience any sexual problems while taking an SSRI, talk with your doctor or therapist. In some cases, sexual difficulties may stem not from the medication, but rather from the underlying depression. If your medication is the problem, your doctor or therapist may suggest one of the following strategies:
- Lowering the dose. Sexual side effects may subside at a lower, although still therapeutic, dose.
- Taking a drug holiday. Depending on how long the drug usually remains in your body, you might stop taking it for a few days before a weekend, if that’s when you hope to have sex. This is hardly spontaneous, but it can work if you carefully follow your doctor’s directions about how to stop and resume your medication. However, there is always a chance that this might cause a relapse.
- Switching to a different drug. Certain antidepressants, such as bupropion (Wellbutrin), mirtazapine (Remeron), TCAs, and MAOIs, are less likely to cause sexual problems. There are some reports that bupropion may actually boost sexual drive and arousal, as well as the intensity or duration of an orgasm.
- Adding a drug. In both men and women, sildenafil (Viagra) may counteract the negative sexual effects of SSRIs. Adding bupropion (Wellbutrin) to your treatment may also help.
What kinds of side effects have you experienced while taking an antidepressant, and how did you deal with them?
Nearly 1 in 10 adults will suffer from some form of depression in a given year, affecting not only them, but also their friends and family. Thankfully, years of research and recent breakthroughs have made this serious illness easier to treat. With Understanding Depression, a special health report from Harvard Medical School, you can stay up-to-date on the latest information on depression symptoms and treatments to improve your life—or the life of someone close to you.
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Comments: 6
*Adding additional medications to manage side effects just makes me more "zombie" like - I don't feel depressed or happy; I just exist.
*Reducing the dosage for me just reduced the effectiveness of the drugs. Increasing the dosage to a level where I receive any theraputic effect just creates side effects.
In reality it just makes me more depressed because nothing really works.