Antidepressants: Get tips to cope with side effects

Most antidepressant side effects aren't dangerous, but they can be bothersome. Here's what to do.

By Mayo Clinic Staff

Introduction

Antidepressants can cause unpleasant side effects. Signs and symptoms such as nausea, weight gain or sleep problems can be common initially. For many people, these improve within weeks of starting an antidepressant. In some cases, however, antidepressants cause side effects that don't go away.

Talk to your doctor or mental health professional about any side effects you're having. For some antidepressants, monitoring blood levels may help determine the range of effectiveness and to what extent dosage can be adjusted to help reduce side effects. Rarely, antidepressants can cause serious side effects that need to be treated right away.

If side effects seem intolerable, you may be tempted to stop taking an antidepressant or to reduce your dose on your own. Don't do it. Your symptoms may return, and stopping your antidepressant suddenly may cause withdrawal-like symptoms. Talk with your doctor to help identify the best options for your specific needs.

Nausea

Nausea typically begins early after starting an antidepressant. It may go away after your body adjusts to the medication.

Consider these strategies:

  • Take your antidepressant with food, unless otherwise directed.
  • Eat smaller, more-frequent meals.
  • Suck on sugarless hard candy.
  • Drink plenty of fluids, such as cool water. Try an antacid or bismuth subsalicylate (Pepto-Bismol).
  • Talk to your doctor about a dosage change or a slow-release form of the medication.

Increased appetite, weight gain

You may gain weight because of fluid retention or lack of physical activity, or because you have a better appetite when your depression symptoms ease up. Some antidepressants are more likely to cause weight gain than others. If you're concerned about weight gain, ask your doctor if this is a likely side effect of the antidepressant being prescribed and discuss ways to address this issue.

Consider these strategies:

  • Cut back on sweets and sugary drinks.
  • Select lower calorie nutritious foods, such as vegetables and fruits, and avoid saturated and trans fats.
  • Keep a food diary — tracking what you eat can help you manage your weight.
  • Seek advice from a registered dietitian.
  • Get regular physical activity or exercise most days of the week.
  • Talk to your doctor about switching medications, but get the pros and cons.

Fatigue, drowsiness

Fatigue and drowsiness are common, especially during early weeks of treatment with an antidepressant.

Consider these strategies:

  • Take a brief nap during the day.
  • Get some physical activity, such as walking.
  • Avoid driving or operating dangerous machinery until the fatigue passes.
  • Take your antidepressant at bedtime if your doctor approves.
  • Talk to your doctor to see if adjusting your dose will help.

Insomnia

Some antidepressants may cause insomnia, making it difficult to get to sleep or stay asleep, so you may be tired during the day.

Consider these strategies:

  • Take your antidepressant in the morning if your doctor approves.
  • Avoid caffeinated food and drinks, particularly late in the day.
  • Get regular physical activity or exercise — but complete it several hours before bedtime so it doesn't interfere with your sleep.
  • If insomnia is an ongoing problem, ask your doctor about taking a sedating medication at bedtime or ask whether taking a low dose of a sedating antidepressant such as trazodone or mirtazapine (Remeron) before bed might help.

Dry mouth

Dry mouth is a common side effect of many antidepressants.

Consider these strategies:

  • Sip water regularly or suck on ice chips.
  • Chew sugarless gum or suck on sugarless hard candy.
  • Avoid tobacco, alcohol and caffeinated beverages because they can make your mouth drier.
  • Breathe through your nose, not your mouth.
  • Brush your teeth twice a day, floss daily and see your dentist regularly. Having a dry mouth can increase your risk of getting cavities.
  • Talk to your doctor or dentist about over-the-counter or prescription medications for dry mouth.
  • If dry mouth continues to be extremely bothersome despite the efforts above, ask your doctor the pros and cons of reducing the dosage of the antidepressant.

Constipation

Constipation is often associated with tricyclic antidepressants because they disrupt normal functioning of the digestive tract and other organ systems. Other antidepressants sometimes cause constipation as well.

Consider these strategies:

  • Drink plenty of water.
  • Eat high-fiber foods, such as fresh fruits and vegetables, brans, and whole grains.
  • Get regular exercise.
  • Take a fiber supplement (Citrucel, Metamucil, others).
  • Ask your doctor for advice on stool softeners if other measures don't work.

Dizziness

Dizziness is more common with tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) than with other antidepressants. These medications can cause low blood pressure, resulting in dizziness.

Consider these strategies:

  • Rise slowly from sitting to standing positions.
  • Use handrails, canes or other sturdy items for support.
  • Avoid driving or operating machinery.
  • Avoid caffeine, tobacco and alcohol.
  • Drink plenty of fluids.
  • Take your antidepressant at bedtime if your doctor approves.

Agitation, restlessness, anxiety

Agitation, restlessness or anxiety can result from the stimulating effect of certain antidepressants. Although having more energy can be a good thing, it may mean you can't relax or sit still even if you want to.

Consider these strategies:

  • Get regular exercise, such as jogging, biking or aerobics, or some type of physical activity, such as walking. Talk to your doctor first about what would be a good type of exercise or physical activity for you.
  • Practice deep-breathing exercises, muscle relaxation or yoga.
  • Consult your doctor about temporarily taking a relaxing or sedating medication or switching to an antidepressant that isn't as stimulating.

Be alert for racing or impulsive thoughts along with high energy. If these develop, talk to your doctor right away because they may be signs of bipolar disorder or another serious disorder.

Sexual side effects

Many antidepressants cause sexual side effects. They can include reduced sex drive and difficulty reaching orgasm. Some antidepressants may cause trouble getting or keeping an erection (erectile dysfunction). Selective serotonin reuptake inhibitors (SSRIs) are more likely to cause sexual side effects than other antidepressants are.

Consider these strategies:

  • Consider a medication that requires only a once-a-day dose, and schedule sexual activity before taking that dose.
  • Talk to your doctor about switching to an antidepressant that may have fewer of these effects, such as bupropion (Wellbutrin, SR, Wellbutrin XL, others), or adjusting your medication to ease sexual side effects.
  • Talk to your partner about your sexual side effects and how they change your needs. Adjusting your sexual routine may be helpful. For example, you may need a longer period of foreplay before having sexual intercourse.
  • Talk with your doctor about options for medications, such as sildenafil (Viagra), that may temporarily ease sexual side effects or treat erectile dysfunction and any associated risks. Avoid over-the-counter herbal supplements that promise increased sexual desire and function — these are not regulated by the Food and Drug Administration (FDA) and some could be dangerous to your health.

Heart-related effects

Depending on your heart health and the type of antidepressant you take, you may need an electrocardiogram (ECG) before or periodically during treatment. The ECG is used to monitor what's called the QT interval to make sure it's not prolonged. A prolonged QT interval is a heart rhythm condition that can increase your risk of serious irregular heart rhythms (arrhythmias).

Certain antidepressants should not be used if you already have heart problems or if you're taking an MAOI. Talk with your doctor about your heart health and any heart medications or other medications that you take.

Genetic variations

Some studies indicate that variations in genes may play a role in the effectiveness and risk of side effects of specific antidepressants. So your genes may, at least in part, determine whether a certain antidepressant will work well for you and whether you're likely to have certain side effects.

Some locations already provide limited genetic testing to help determine antidepressant choice, but testing is not routine and it's not always covered by insurance.

More studies are being done to determine what might be the best antidepressant choice based on genetic makeup. However, genetic testing is a part of — not a replacement for — a thorough psychiatric exam and clinical decisions.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Sept. 12, 2019 See more In-depth

See also

  1. Addison's disease
  2. Adjustment disorders
  3. Adrenal fatigue: What causes it?
  4. Alzheimer's: New treatments
  5. Alzheimer's 101
  6. Understanding the difference between dementia types
  7. Alzheimer's disease
  8. Alzheimer's drugs
  9. Alzheimer's genes
  10. Alzheimer's prevention: Does it exist?
  11. Alzheimer's stages
  12. Ambien: Is dependence a concern?
  13. Antidepressant withdrawal: Is there such a thing?
  14. Antidepressants and alcohol: What's the concern?
  15. Antidepressants and weight gain: What causes it?
  16. Antidepressants: Can they stop working?
  17. Antidepressants: Selecting one that's right for you
  18. Antidepressants: Which cause the fewest sexual side effects?
  19. Antidepressants and pregnancy
  20. Atypical antidepressants
  21. Back pain
  22. Binge-eating disorder
  23. Blood Basics
  24. Borderline personality disorder
  25. Breastfeeding and medications
  26. Dr. Wallace Video
  27. Dr. Mark Truty (surgery, MN) better outcomes with chemo
  28. Can zinc supplements help treat hidradenitis suppurativa?
  29. Hidradenitis suppurativa wound care
  30. Celiac disease
  31. Child abuse
  32. Chronic traumatic encephalopathy
  33. CJD - Creutzfeldt-Jakob Disease
  34. Clinical depression: What does that mean?
  35. Clinical trials for hidradenitis suppurativa
  36. Coconut oil: Can it cure hypothyroidism?
  37. Complete blood count (CBC)
  38. Complicated grief
  39. Compulsive sexual behavior
  40. Concussion
  41. Concussion in children
  42. Concussion Recovery
  43. Concussion Telemedicine
  44. Coping with the emotional ups and downs of psoriatic arthritis
  45. Coping with the stress of hidradenitis suppurativa
  46. COVID-19 and your mental health
  47. Creating a hidradenitis suppurativa care team
  48. Creutzfeldt-Jakob disease
  49. Cushing syndrome
  50. Cyclothymia (cyclothymic disorder)
  51. Delirium
  52. Depression and anxiety: Can I have both?
  53. Depression, anxiety and exercise
  54. What is depression? A Mayo Clinic expert explains.
  55. Depression during pregnancy
  56. Depression in women: Understanding the gender gap
  57. Depression (major depressive disorder)
  58. Depression: Supporting a family member or friend
  59. Diabetes and depression: Coping with the two conditions
  60. Diagnosing Alzheimer's
  61. Did the definition of Alzheimer's disease change?
  62. Dissociative disorders
  63. Vitamin C and mood
  64. Drug addiction (substance use disorder)
  65. Electroconvulsive therapy (ECT)
  66. Fatigue
  67. Fibromyalgia
  68. HABIT program orientation
  69. Hangovers
  70. Hashimoto's disease
  71. Headache
  72. Hidradenitis suppurativa
  73. Hidradenitis suppurativa and biologics: Get the facts
  74. Hidradenitis suppurativa and diet: What's recommended?
  75. Hidradenitis suppurativa and sleep: How to get more zzz's
  76. Hidradenitis suppurativa: Tips for weight-loss success
  77. Hidradenitis suppurativa: What is it?
  78. Hidradenitis suppurativa: When does it appear?
  79. Hidradenitis suppurativa: Where can I find support?
  80. How opioid use disorder occurs
  81. How to tell if a loved one is abusing opioids
  82. Hyperparathyroidism
  83. Hypoparathyroidism
  84. Hypothyroidism: Can calcium supplements interfere with treatment?
  85. Hypothyroidism diet
  86. Hypothyroidism and joint pain?
  87. Hypothyroidism: Should I take iodine supplements?
  88. Hypothyroidism symptoms: Can hypothyroidism cause eye problems?
  89. Hypothyroidism (underactive thyroid)
  90. Insomnia
  91. Insomnia: How do I stay asleep?
  92. Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills
  93. Intervention: Help a loved one overcome addiction
  94. Is depression a factor in rheumatoid arthritis?
  95. Kratom for opioid withdrawal
  96. Lack of sleep: Can it make you sick?
  97. Lecanemab for Alzheimer's disease
  98. Living better with hidradenitis suppurativa
  99. Low blood pressure (hypotension)
  100. Male depression: Understanding the issues
  101. Managing Headaches
  102. Managing hidradenitis suppurativa: Early treatment is crucial
  103. Hidradenitis suppurativa-related health risks
  104. MAOIs and diet: Is it necessary to restrict tyramine?
  105. Marijuana and depression
  106. Mayo Clinic Minute: 3 tips to reduce your risk of Alzheimer's disease
  107. Mayo Clinic Minute: Alzheimer's disease risk and lifestyle
  108. Mayo Clinic Minute: New definition of Alzheimer's changes
  109. Mayo Clinic Minute: Prevent migraines with magnetic stimulation
  110. Mayo Clinic Minute: Restless legs syndrome in kids
  111. Mayo Clinic Minute: Weathering migraines
  112. Mayo Clinic Minute: Women and Alzheimer's Disease
  113. Medication overuse headaches
  114. Meditation
  115. Memory loss: When to seek help
  116. Mental health: Overcoming the stigma of mental illness
  117. Mental health providers: Tips on finding one
  118. Mental health
  119. Mental illness
  120. Migraine
  121. What is a migraine? A Mayo Clinic expert explains
  122. Migraine medicines and antidepressants
  123. Migraine FAQs
  124. Migraine treatment: Can antidepressants help?
  125. Migraines and gastrointestinal problems: Is there a link?
  126. Migraines and Vertigo
  127. Migraines: Are they triggered by weather changes?
  128. Alleviating migraine pain
  129. Mild cognitive impairment (MCI)
  130. Mindfulness exercises
  131. Monoamine oxidase inhibitors (MAOIs)
  132. Natural remedies for depression: Are they effective?
  133. Nervous breakdown: What does it mean?
  134. New Alzheimers Research
  135. Nicotine dependence
  136. Occipital nerve stimulation: Effective migraine treatment?
  137. Ocular migraine: When to seek help
  138. Opioid stewardship: What is it?
  139. Oppositional defiant disorder (ODD)
  140. Pain and depression: Is there a link?
  141. Pancreatic cancer
  142. Pancreatic Cancer
  143. What is pancreatic cancer? A Mayo Clinic expert explains
  144. Infographic: Pancreatic Cancer: Minimally Invasive Surgery
  145. Pancreatic Cancer Survivor
  146. Infographic: Pancreatic Cancers-Whipple
  147. Perimenopause
  148. Pituitary tumors
  149. Polymyalgia rheumatica
  150. Poppy seed tea: Beneficial or dangerous?
  151. Post COVID syndrome
  152. Premenstrual dysphoric disorder
  153. Premenstrual syndrome (PMS)
  154. Prescription drug abuse
  155. Prescription sleeping pills: What's right for you?
  156. Progressive supranuclear palsy
  157. Psychotherapy
  158. Reducing the discomfort of hidradenitis suppurativa: Self-care tips
  159. Restless legs syndrome
  160. Salt craving: A symptom of Addison's disease?
  161. Schizoaffective disorder
  162. Seasonal affective disorder (SAD)
  163. Seasonal affective disorder treatment: Choosing a light box
  164. Selective serotonin reuptake inhibitors (SSRIs)
  165. Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  166. Sleep disorders
  167. Sleep tips
  168. Soy: Does it worsen hypothyroidism?
  169. Staying active with hidradenitis suppurativa
  170. Stress symptoms
  171. Sundowning: Late-day confusion
  172. Support groups
  173. Surgery for hidradenitis suppurativa
  174. Symptom Checker
  175. Tapering off opioids: When and how
  176. Tinnitus and antidepressants
  177. Transcranial magnetic stimulation
  178. Traumatic brain injury
  179. Treating hidradenitis suppurativa: Explore your options
  180. Treating hidradenitis suppurativa with antibiotics and hormones
  181. Treatment of parathyroid disease at Mayo Clinic
  182. Treatment-resistant depression
  183. Tricyclic antidepressants and tetracyclic antidepressants
  184. Unexplained weight loss
  185. Vagus nerve stimulation
  186. Valerian: A safe and effective herbal sleep aid?
  187. Vascular dementia
  188. Video: Alzheimer's drug shows early promise
  189. Video: Vagus nerve stimulation
  190. Vitamin B-12 and depression
  191. What are opioids and why are they dangerous?
  192. What are the signs and symptoms of hidradenitis suppurativa?
  193. Wilson's disease
  194. Xylazine
  195. Young-onset Alzheimer's