Antidepressant Side Effects: What to Know and What to Report

What most people can expect

The National Institute of Mental Health (NIMH) says common side effects of SSRIs and other antidepressants include upset stomach, headache and sexual dysfunction. It says they are generally mild and tend to go away with time. Not everyone has them, and a prescriber may be able to suggest ways to make them easier.

If a side effect is hard to live with, say so. That is useful information and not a complaint. NIMH notes that people who are sensitive to side effects sometimes benefit from a prescriber changing how the medicine is started or when it is taken. Those changes are for your prescriber to make with you.

Common side effects by group

These lists come from FDA labels or MedlinePlus for one medicine in each group. They are examples, and other medicines in a group can differ. Your prescriber or pharmacist can give you the list for yours.

• SSRIs. For sertraline, the most common effects on the label are mainly digestive, such as nausea and loose stool, along with tremor, sweating, lower appetite and sexual effects.
• SNRIs. For extended-release venlafaxine, the label's common list includes nausea, sleepiness, dry mouth, constipation, sweating, less appetite and several sexual effects.
• Bupropion. For extended-release bupropion, the label's common list includes insomnia, agitation, anxiety, tremor and a pounding heartbeat, along with dry mouth, nausea, dizziness and other effects.
• Tricyclics. MedlinePlus lists these for amitriptyline, among others: drowsiness, dry mouth, constipation, difficulty urinating, blurred vision, changes in sex drive or ability, sweating, and changes in appetite or weight.
• MAOIs. The tranylcypromine label lists dry mouth, dizziness, insomnia, sedation, headache, overexcitement, constipation, blurred vision and tremor.

The boxed warning for people under 25

A boxed warning is a safety warning set apart in a box at the top of an FDA label. Antidepressant labels, including those for sertraline, venlafaxine and bupropion, warn of an increased risk of suicidal thoughts and behaviors in children, teens and young adults taking these medicines. The labels tell prescribers to monitor everyone taking an antidepressant closely for worsening or for new suicidal thoughts.

NIMH says this risk is seen in children, teenagers and young adults under 25, especially in the first few weeks after starting or when the dose changes, and that people of all ages should be watched closely during that time. The bupropion label also notes that depression itself is linked to suicide risk, so untreated symptoms matter as well. If you are in crisis, call or text 988, or call 911. Locascio Wellness does not provide emergency services.

What to report right away

The sertraline Medication Guide says to call your healthcare provider right away, or 911 if it is an emergency, about the changes below, especially if they are new, worse or worrying. You do not need to be sure it is the medicine before you call.

• Thoughts about suicide or dying, or new or worse depression, anxiety or panic attacks.
• Feeling agitated, restless, angry or irritable, acting on dangerous impulses, or an increase in activity or talking.
• Signs of serotonin syndrome, which can be life-threatening: agitation, hallucinations, racing heartbeat, high or low blood pressure, muscle twitching or rigidity, sweating or fever, and nausea, vomiting or diarrhea.

Risks specific to certain medicines

Some warnings belong to particular groups. These are worth knowing so you can tell a prescriber what applies to you.

If side effects are getting in the way

NIMH says not to stop a prescribed medicine, even if you feel better, without help from a health care provider, because stopping too soon may cause unpleasant or harmful side effects. It adds that you should call right away if you are worried a medicine might be doing more harm than good. NIMH also says serious side effects can be reported to the FDA MedWatch program.

A licensed psychiatrist on our team, a Doctor of Osteopathic Medicine with more than three decades of practice, offers online depression treatment by secure video for people physically in Pennsylvania or New York during each visit. If you are worried about a side effect today, call the prescriber who gave you the medicine first. To ask whether our psychiatrist can help with your care going forward, use our medication care contact form. Our therapists do not prescribe.