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understanding antidepressants

This article gives information about antidepressants. Antidepressants can help with different mental health problems, including low mood, depression, and anxiety.

overview

>Antidepressant medications are used to treat depression and other mood disorders.
>There are different types of antidepressants. You may need to try different ones before finding one that works for you.
>You may get side effects from antidepressants. Talk to your doctor if you get side effects that cause you problems.
>You may get withdrawal symptoms when you stop taking antidepressant medication. Talk to your doctor before you stop taking them. Your doctor may take you off your medication slowly if you have been taking them for a long time.
>Antidepressant medication can affect other medications. Tell your doctor if you take any other medication.

what are antidepressants?

Your doctor may offer you antidepressants if you have very low mood or symptoms of depression. They can also help if you have other mental health problems, including anxiety. Scientists aren't sure how antidepressants work. But they think that they may work by increasing levels of certain chemicals in your brain that help improve your mood and emotions.

Antidepressants should start to work within 2-3 weeks. There is no set time for how long you should take antidepressants. Your doctor may ask you to take your antidepressants for 6 months after your symptoms are gone. This can help stop your symptoms coming back. Your doctor will work out how much you should take, and for how long. Antidepressants are not addictive. But you may get withdrawal symptoms if you stop taking them suddenly.
What are the different types of antidepressants?

All antidepressants work in different ways. One type of antidepressant may suit you more than another. Here, we give an overview of the different types.
Selective serotonin re-uptake inhibitors (SSRIs)

The National Institute for Health and Clinical Excellence (NICE) suggests that SSRIs have fewer side effects than the other types of antidepressants. All the following medications treat low mood and depression. Some may also treat other conditions, including anxiety, bulimia, panic disorder, and obsessive-compulsive disorder.

serotonin-noradrenaline reuptake inhibitors (SNRIs)

SNRIs are similar to SSRIs. They treat depression and chronic pain.

tricyclic antidepressants

Tricyclic antidepressants can treat depression, panic disorder, obsessive compulsive disorder and migraine. Tricyclic antidepressants can take 2 to 4 weeks to work. These are older medicines, and generally have more side effects than other antidepressants.

mono-amine oxidase inhibitors (MAOIs)

MAOIs are an older antidepressant. These are not prescribed as much. Your doctor should monitor you if you take these. You cannot eat certain foods if you take these. Your doctor should give you more information if they prescribe these for you.

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what are the side effects of antidepressants?

Different antidepressants will have different side effects. The newer antidepressants should have fewer side effects than the older ones. People can have different reactions to medication.

You should get a patient information leaflet with your medication. This leaflet will tell you all the possible side effects you might get. The table below tells you about the common side effects.

what if I want to stop taking antidepressants?

If you have been taking antidepressants for a few weeks you should not stop taking them suddenly. Antidepressants are not addictive but your body can become used to them. If you stop taking them suddenly you get withdrawal symptoms.

You should talk to your doctor before stopping your medication. You can stop taking them slowly, which can help reduce withdrawal effects. People can respond to coming off antidepressants differently. Some people will have no effects at all. Some common withdrawal effects are in the table below.

do antidepressants affect other medication?

This section is just a summary. You should tell your doctor or pharmacist about any medicines you take before you start or stop other medications. This includes over the counter medication, herbal or complementary remedies or medicines such as:

- Ibuprofen
- Illegal drugs
- Other antidepressants
- St John's Wort
- Anaesthetics

Read through the medicine leaflet before you start taking any medicine.

do any foods affect antidepressants?

There are some foods that have an amino acid (protein) called tyramine that you should not eat if you are taking MAOIs. Tyramine can build up in your body if you eat it when you are taking MAOIs. Examples of foods that have this protein are:

- Cheese
- Pickled or salted meats or fish
- Overripe fruits and vegetables
- Oxo, Marmite, or Bovril

If you are taking this medication, ask your doctor about any foods that you should not eat.

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does alcohol affect my antidepressants?

Drinking alcohol while taking antidepressants is not advised because alcohol can make depression worse. It can also increase the side effects of some antidepressants, like drowsiness, dizziness, and co-ordination problems.

To avoid alcohol-related harm, the NHS recommends that you should drink no more than 14 units of alcohol a week. It's best to spread this evenly over three or more days.

You should not drink certain wines or beers if you are taking MAOIs. You should ask your pharmacist or doctor for more information.

can I drive when taking antidepressants?

Some antidepressants can affect your ability to drive. You may feel drowsy from your medication, which can affect your reaction time. If your antidepressants make you drowsy you should not drive.

You should tell the DVLA if you are taking medication that may affect your driving. You should also tell them if you have a medical condition that could affect your driving.

You can find out more information about 'Driving and mental illness' here.
What else should I consider before taking antidepressants?

sex

Taking antidepressants may affect your sex life. Antidepressants can make you feel tired and can affect your hormones.

side effects include:

- Lower sex drive
- Problems with getting an erection
- Difficulty ejaculating or having an orgasm
- Poor vaginal lubrication

If you are having these problems, talk to your doctor. You might be able to change medication, or the amount you take.

pregnancy

You can take some antidepressants if you are pregnant, but you should talk to your doctor. You may want to stay on antidepressants during your pregnancy, if you think your symptoms will come back. Some antidepressants may be better for you during pregnancy.

If you are pregnant, some antidepressants can affect the baby. Some possible effects can be:

- Low birth weight
- Being uneasy and bad tempered
- Heart disease
- Pulmonary hypertension (high blood pressure in the blood vessels between your lungs and heart)

Talk to your doctor if you are pregnant, or plan on getting pregnant.

breast feeding

Small amounts of antidepressants can pass into your breast milk. Talk to your doctor or midwife about the risks and benefits of breastfeeding. Some antidepressants are better if you are breastfeeding, and your doctor can tell you about this.

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