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 and current health topics, like COVID-19, plus expertise on managing health.

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. After a flood, are food and medicines safe to use?
  5. Alzheimer's: New treatments
  6. Alzheimer's 101
  7. Understanding the difference between dementia types
  8. Alzheimer's disease
  9. Alzheimer's disease: Can exercise prevent memory loss?
  10. Alzheimer's drugs
  11. Alzheimer's genes
  12. Alzheimer's nose spray: New Alzheimer's treatment?
  13. Alzheimer's prevention: Does it exist?
  14. Alzheimer's stages
  15. Ambien: Is dependence a concern?
  16. Antidepressant withdrawal: Is there such a thing?
  17. Antidepressants and alcohol: What's the concern?
  18. Antidepressants and weight gain: What causes it?
  19. Antidepressants: Can they stop working?
  20. Antidepressants: Selecting one that's right for you
  21. Antidepressants: Which cause the fewest sexual side effects?
  22. Antidepressants and pregnancy
  23. Atypical antidepressants
  24. Atypical depression
  25. Back pain
  26. Bedtime routines: Not just for babies
  27. Binge-eating disorder
  28. Blood Basics
  29. Borderline personality disorder
  30. Breastfeeding and medications
  31. Dr. Wallace Video
  32. Dr. Mark Truty (surgery, MN) better outcomes with chemo
  33. Parathyroid
  34. Can music help someone with Alzheimer's?
  35. Can zinc supplements help treat hidradenitis suppurativa?
  36. Can't sleep? Try daytime exercise
  37. Hidradenitis suppurativa wound care
  38. Celiac disease
  39. Chase away the winter blues
  40. Child abuse
  41. Chronic traumatic encephalopathy
  42. CJD - Creutzfeldt-Jakob Disease
  43. Clinical depression: What does that mean?
  44. Clinical trials for hidradenitis suppurativa
  45. Coconut oil: Can it cure hypothyroidism?
  46. Coffee after dinner? Make it decaf
  47. Complete blood count (CBC)
  48. Complicated grief
  49. Compulsive sexual behavior
  50. Concussion
  51. Concussion in children
  52. Concussion Recovery
  53. Concussion Telemedicine
  54. Coping with the stress of hidradenitis suppurativa
  55. Coping with the emotional ups and downs of psoriatic arthritis
  56. COVID-19 and your mental health
  57. Creating a hidradenitis suppurativa care team
  58. Creutzfeldt-Jakob disease
  59. Cushing syndrome
  60. Cyclothymia (cyclothymic disorder)
  61. Delirium
  62. Depression and anxiety: Can I have both?
  63. Depression, anxiety and exercise
  64. Depression: Diagnosis is key
  65. Depression during pregnancy
  66. Depression in women: Understanding the gender gap
  67. Depression (major depressive disorder)
  68. Depression: Provide support, encouragement
  69. Depression: Supporting a family member or friend
  70. Diabetes and depression: Coping with the two conditions
  71. Diagnosing Alzheimer's
  72. Dissociative disorders
  73. Vitamin C and mood
  74. Drug addiction (substance use disorder)
  75. Electroconvulsive therapy (ECT)
  76. Fatigue
  77. Fibromyalgia
  78. Fibromyalgia and acupuncture
  79. Fibromyalgia: Linked to other health problems?
  80. HABIT program orientation
  81. Hangovers
  82. Hashimoto's disease
  83. Headache
  84. Hidradenitis suppurativa
  85. Hidradenitis suppurativa and biologics: Get the facts
  86. Hidradenitis suppurativa and diet: What's recommended?
  87. Hidradenitis suppurativa and sleep: How to get more zzz's
  88. Hidradenitis suppurativa: Tips for weight-loss success
  89. Hidradenitis suppurativa: What is it?
  90. Hidradenitis suppurativa: When does it appear?
  91. Hidradenitis suppurativa: Where can I find support?
  92. How opioid addiction occurs
  93. How to tell if a loved one is abusing opioids
  94. Hyperparathyroidism
  95. Hypoparathyroidism
  96. Hypothyroidism: Can calcium supplements interfere with treatment?
  97. Hypothyroidism diet
  98. Hypothyroidism and joint pain?
  99. Hypothyroidism: Should I take iodine supplements?
  100. Hypothyroidism symptoms: Can hypothyroidism cause eye problems?
  101. Hypothyroidism (underactive thyroid)
  102. Insomnia
  103. Insomnia: How do I stay asleep?
  104. Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills
  105. Intervention: Help a loved one overcome addiction
  106. Is depression a factor in rheumatoid arthritis?
  107. Is fibromyalgia hereditary?
  108. Is the definition of Alzheimer's disease changing?
  109. Kratom for opioid withdrawal
  110. Lack of sleep: Can it make you sick?
  111. Living better with hidradenitis suppurativa
  112. Low blood pressure (hypotension)
  113. Male depression: Understanding the issues
  114. Managing Headaches
  115. Managing hidradenitis suppurativa: Early treatment is crucial
  116. Hidradenitis suppurativa-related health risks
  117. MAOIs and diet: Is it necessary to restrict tyramine?
  118. Marijuana and depression
  119. Mayo Clinic Minute: 3 tips to reduce your risk of Alzheimer's disease
  120. Mayo Clinic Minute: Alzheimer's disease risk and lifestyle
  121. Mayo Clinic Minute New definition of Alzheimer's changes
  122. Mayo Clinic Minute: Prevent migraines with magnetic stimulation
  123. Mayo Clinic Minute: Restless legs syndrome in kids
  124. Mayo Clinic Minute Weathering migraines
  125. Mayo Clinic Minute: Women and Alzheimer's Disease
  126. Medication overuse headaches
  127. Meditation
  128. Mediterranean diet recipes
  129. Memory loss: When to seek help
  130. Mental health: Overcoming the stigma of mental illness
  131. Mental health providers: Tips on finding one
  132. Mental health
  133. Mental illness
  134. Migraine
  135. What is a migraine? A Mayo Clinic expert explains
  136. Migraine medications and antidepressants
  137. Migraine FAQs
  138. Migraine treatment: Can antidepressants help?
  139. Infographic: Migraine Treatments: Botox & Nerve Blocking
  140. Migraines and gastrointestinal problems: Is there a link?
  141. Migraines and Vertigo
  142. Migraines: Are they triggered by weather changes?
  143. Alleviating migraine pain
  144. Mild cognitive impairment (MCI)
  145. Mindfulness exercises
  146. Monoamine oxidase inhibitors (MAOIs)
  147. Natural remedies for depression: Are they effective?
  148. Nervous breakdown: What does it mean?
  149. New Alzheimers Research
  150. Nicotine dependence
  151. Not tired? Don't go to bed
  152. Occipital nerve stimulation: Effective migraine treatment?
  153. Ocular migraine: When to seek help
  154. Oppositional defiant disorder (ODD)
  155. Pain and depression: Is there a link?
  156. Pancreatic cancer
  157. Pancreatic Cancer
  158. What is pancreatic cancer? A Mayo Clinic expert explains
  159. Infographic: Pancreatic Cancer: Minimally Invasive Surgery
  160. Pancreatic Cancer Survivor
  161. Infographic: Pancreatic Cancers-Whipple
  162. Perimenopause
  163. Pituitary tumors
  164. Polymyalgia rheumatica
  165. Premenstrual dysphoric disorder
  166. Premenstrual syndrome (PMS)
  167. Prescription drug abuse
  168. Prescription sleeping pills: What's right for you?
  169. Progressive supranuclear palsy
  170. Psychotherapy
  171. Reducing the discomfort of hidradenitis suppurativa: Self-care tips
  172. Restless legs syndrome
  173. Salt craving: A symptom of Addison's disease?
  174. Schizoaffective disorder
  175. Seasonal affective disorder (SAD)
  176. Seasonal affective disorder treatment: Choosing a light box
  177. Selective serotonin reuptake inhibitors (SSRIs)
  178. Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  179. Skip booze for better sleep
  180. Sleep disorders
  181. Sleep tips
  182. Soy: Does it worsen hypothyroidism?
  183. Staying active with hidradenitis suppurativa
  184. Stop your next migraine before it starts
  185. Stress symptoms
  186. Sundowning: Late-day confusion
  187. Support groups
  188. Surgery for hidradenitis suppurativa
  189. Symptom Checker
  190. Tapering off opioids: When and how
  191. Tinnitus and antidepressants
  192. Transcranial magnetic stimulation
  193. Traumatic brain injury
  194. Treating hidradenitis suppurativa: Explore your options
  195. Treating hidradenitis suppurativa with antibiotics and hormones
  196. Treatment-resistant depression
  197. Tricyclic antidepressants and tetracyclic antidepressants
  198. Unexplained weight loss
  199. Vagus nerve stimulation
  200. Valerian: A safe and effective herbal sleep aid?
  201. Vascular dementia
  202. Video: Alzheimer's drug shows early promise
  203. Video: Vagus nerve stimulation
  204. Vitamin B-12 and depression
  205. What are opioids and why are they dangerous?
  206. What are the signs and symptoms of hidradenitis suppurativa?
  207. What is reflexology?
  208. Wilson's disease
  209. Wilson's syndrome: An accepted medical diagnosis?
  210. Young-onset Alzheimer's