What to Do About Antidepressant Side Effects

Practical Tips to Address Bothersome Side Effects from Antidepressants

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Maria's depression was difficult to treat. Various medications had been tried to no avail, but after several months of treatment, Maria has eventually become stable on a combination of two antidepressants.

She’s now able to do her usual activities and is motivated to go back to work, something she has struggled to do for a while. But despite her improvement, she is starting to see side effects from her medications and they're quite bothersome.

Maria begins to consider discontinuing her medications prematurely.

Antidepressant side effects are real and can negatively affect your willingness to take medications. Many patients like Maria consider stopping the medication even at the risk of relapse because of distressing side effects.

Dealing With Common Antidepressant Side Effects

There are some practical ways to cope with particular antidepressant side effects like insomnia, weight gain, sexual dysfunction, dry mouth, constipation, nausea and/or vomiting, memory lapses, dizziness and agitation or anxiety. Remember, do not discontinue your medication without talking to your doctor first as this can cause other serious issues. 


Some antidepressants like selective serotonin reuptake inhibitors (SSRIs) such as Zoloft (sertraline), Paxil (paroxetine), Prozac (fluoxetine) and Lexapro (escitalopram), are highly stimulating, so they can cause insomnia when taken in the afternoon or at bedtime.

Be sure to take this type of medication in the morning. Discuss with your physician the use of a sedating medication such as trazodone or a sedative-hypnotic drug along with the antidepressant if you are still having trouble sleeping. If you want to take only one pill, talk to your doctor about switching to a sedating antidepressant such as Remeron (mirtazapine).

Moreover, sleep hygiene should be practiced. Avoid naps and intake of caffeinated drinks such as coffee and soda in the afternoon and evening. Make sure you regular exercise and do physical activities during the day. Also, use your bedroom only for sleep and sex and not for recreational activities.

Weight gain

Regular exercise is weight gain’s antidote. If there is no medical contraindication, you may consider jogging, walking, or swimming. To reduce some excess and unwanted fat, keep yourself busy with physical and recreational activities.

Diet has always been a part of any weight control regimen. Monitor your carbohydrate intake. Ice cream, chocolates, and other high-caloric foods should be reduced. If none of the above works, talk to your doctor about switching your medication.

Sexual dysfunction

Sexual dysfunction happens too often but is rarely asked about or discussed in the clinic. Some physicians and patients feel embarrassed about this subject. When you have concerns, be open with your physician.

Discuss the possibility of switching medication to an antidepressant such as Wellbutrin (bupropion) or Remeron (mirtazapine) that doesn’t significantly impair sexual functioning. Another option instead of switching is to add another drug such as bupropion, yohimbine or even mirtazapine to counteract the sexual side effect.

How do you know if the sexual dysfunction is from the medication rather than from depression? If the dysfunction persists despite successful remission of depression, then you should consider other causes such as drug-induced dysfunction or other medical causes like diabetes.

Dry mouth

Tricyclic antidepressants such as Anafranil (clomipramine), Tofranil (imipramine) and Elavil (amitriptyline) are notorious for causing dry mouth. Because they are some of the earliest antidepressants created, tricyclic medications have more side effects than newer medications do. They are still be useful for certain people, however.

To combat dry mouth, try ice chips. Frequent sips of water should also help. To avoid dental cavities, try sugarless candy or sugar-free gum.


Like dry mouth, constipation is usually caused by tricylclic antidepressants. To prevent constipation, make sure you are drinking enough water and be sure to eat foods high in fiber such as vegetables and fruits. Consider stool softeners if the above interventions fail. 

Nausea and vomiting

Frequently, patients stop feeling nauseous within two weeks. Take the medication with food. If none of that helps, talk to your doctor about possibly reducing the dose of your medication or trying antacid or bismuth salicylate (Pepto-Bismol), As with any side effect, if it becomes intolerable, talk to your doctor about switching your medication.

Memory lapses

If given permission by your doctor, try to reduce the dose. Also, discuss with your physician the possibility of switching antidepressants, particularly if reducing your dose doesn’t alleviate your concern, and avoid medications with these types of side effects.

Avoid mixing the antidepressant with alcohol. The alcohol-drug interaction only worsens the memory and cognitive functioning. While on psychotropic drugs, be careful driving and using mechanized equipment.


While still in bed, sit up for 30 seconds, then stand up for another 30 seconds while holding a rail, a table, or a chair before walking. Take the medication at bedtime. Some people use support hose with success.

Agitation or anxiety

Some people benefit from a brief use of a sedative (benzodiazepine) such as Ativan (lorazepam). Breathing exercises and progressive muscle relaxation should also help.

Give it Some Time

In general, some side effects such as gastrointestinal upset and insomnia may resolve within a couple weeks. Give your body some time to adjust. Patience is the key. However, be on guard. When side effects occur, especially if they become intolerable, address them with your doctor promptly. Don't try to be your own doctor.

Collaborating with your physician is an effective way to cope with mental illness and medication problems. Treatment options such as the need to switch or reduce medications should be discussed in an open and accepting manner.

About the Author:
Dr. Michael G. Rayel is an­ author (First Aid to Mental Illness­ - Finalist, Reader’s Preference Choice Award 2002), speaker, workshop leader, and psychiatrist. His books are available at major online bookstores.

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