When Your Antidepressant Makes You Tired

Strategies to Help Wake You Up

Fatigue From an Antidepressant
Credit: Paul Bradbury/Getty Images

Side-effects from antidepressants are hard to avoid. Fatigue is one of them. This mostly is true of tricyclic antidepressants like Elavil (amitriptyline) and Tofranil (imipramine), which doctors don't often prescribe any more. But even the newer classes of antidepressants—selective serotonin reuptake inhibitors (SSRIs) such as Prozac (fluoxetine), and serotonin and norepinephrine reuptake inhibitors (SNRIs) such as Cymbalta (duloxetine)—can lay you low.

Given that depression itself can make you feel exhausted, it can be frustrating to find that the medication you're taking to treat it isn't helping. If you're dealing with this particular problem, here are some ways you may be able to get the benefits of your medication without constantly feeling like you need a nap.

Why Antidepressants Cause Fatigue

Certain antidepressants work by acting on brain chemicals called neurotransmitters—in particular norepinephrine and serotonin—causing them to linger in the spaces between nerve cells where they carry out their job of regulating mood. At the same time, though, these medications affect other neurotransmitters, including histamine and acetylcholine, sometimes leading to unpleasant side effects such as dry mouthblurry vision, weight gain, and sedation. It's this last side effect that may be responsible for the fatigue you experience when you take an antidepressant.

Ways to Perk Up If Your Meds Are Making Your Tired

You may be tempted to give in to exhaustion and set up camp on your couch, but there are other things you can do if your antidepressant is wiping you out. First, though, be very clear about what you shouldn't do if you're truly fighting to keep your eyes open: First, do not get behind the wheel of your car.

Let someone else do the driving, call a car service or cab, or use public transportation until you've found a workaround for your fatigue.

Second, steer clear of alcohol and any medications that also tend to be sedating. The combo of either with your antidepressant could make your fatigue worse.

Here are some possibilities.

  • Make time to nap during the day. This doesn't mean you have to climb under the covers and snooze the afternoon away. According to the National Sleep Foundation, just 20 minutes of low-intensity activity sleep is enough to leave most people feeling refreshed and energized. In fact, more shut-eye than that can make you even groggier.
  • Get some exercise. It sounds counterintuitive—how could moving possibly be helpful when the last thing you feel like doing is moving? A 2008 study at the University of Georgia found that regular low-intensity could reduce fatigue by as much as 65 percent, for example. This was especially true of people in the study who did low-intensity exercise as opposed to moderate-intensity activity. That means that a leisurely walk could do more to perk you up than, say, a challenging stint on an exercise bike.
  • Pop your pill at bedtime. Unless there's some reason your doctor would prefer you down your depression medication in the morning or during the day, taking it at night may help you fall asleep more easily so you get the rest you need to feel more alert during waking hours. 
  • Wait it out. Seriously. For most people, the side effects of antidepressants wear off as their bodies become adjusted to the medication. If after several weeks you're still feeling zonked, you and your doctor may need to go back to the drawing board and try a different drug or supplement your medication with a second drug that's stimulating, such as such as Provigil (modafinil).

Sources:

Puetz TW, Flowers SS, O'Connor PJ. "A Randomized Controlled Trial of the Effect of Aerobic Exercise Training on Feelings of Energy and Fatigue in Sedentary Young Adults With Persistent Fatigue." Psychother Psychosom. 2008;77(3):167-74.

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