Antidepressants are commonly prescribed to manage mental health conditions such as major depressive disorder (MDD) and anxiety disorders. While these medications can be highly effective, they often come with side effects that vary depending on the type of antidepressant and individual response.
This guide explores the different types of antidepressants, their uses, and the potential side effects associated with each.
What Are Antidepressants and How Do They Function?
Antidepressants are medications designed to balance neurotransmitter levels in the brain, such as serotonin, norepinephrine, and dopamine. These chemicals play a crucial role in regulating mood, emotional stability, and overall mental well-being.
There are various types of antidepressants, each working in slightly different ways. While some are more effective for specific conditions, all antidepressants have the potential to cause side effects.
It’s important to understand that individual responses to antidepressants can differ significantly. Some individuals may experience no side effects, while others may encounter mild to severe reactions. Finding the right medication often requires a process of trial and error under the supervision of a healthcare provider.
SNRIs: How They Work, Benefits, and Side Effects
Serotonin-norepinephrine reuptake inhibitors (SNRIs) enhance the levels of both serotonin and norepinephrine in the brain, improving mood and reducing anxiety.
Common SNRIs:
- Venlafaxine (Effexor XR)
- Desvenlafaxine (Pristiq)
- Duloxetine (Cymbalta)
Conditions Treated:
- Generalized anxiety disorder
- Depression
- Fibromyalgia
- Nerve pain (e.g., diabetic neuropathy)
Common Side Effects:
- Nausea
- Headaches
- Dizziness
- Dry mouth
- Insomnia or excessive drowsiness
- Loss of appetite
- Constipation
- Sweating
- Sexual dysfunction (less common than SSRIs)
- Increased blood pressure (in some cases)
TCAs: Uses, Benefits, and Side Effects
Tricyclic antidepressants (TCAs) are an older class of antidepressants that increase serotonin and norepinephrine levels while also affecting acetylcholine, a neurotransmitter involved in muscle and nerve function.
Common TCAs:
- Imipramine (Tofranil)
- Amitriptyline (Elavil)
- Nortriptyline (Pamelor)
Conditions Treated:
- Depression
- Fibromyalgia
- Nerve pain
- Migraine prevention
Common Side Effects:
- Drowsiness
- Dry mouth
- Constipation
- Blurred vision
- Dizziness
- Weight gain
- Sexual dysfunction
- Rapid heart rate
Compared to SSRIs and SNRIs, TCAs are more likely to cause bothersome side effects, such as dry mouth, blurred vision, and constipation.
MAOIs: What You Need to Know
Monoamine oxidase inhibitors (MAOIs) are less commonly prescribed today due to their potential for serious side effects and interactions with certain foods and medications. They work by preventing the breakdown of serotonin, norepinephrine, and dopamine.
Common MAOIs:
- Selegiline (Emsam)
- Phenelzine (Nardil)
- Tranylcypromine (Parnate)
Conditions Treated:
- Panic disorder
- Social anxiety disorder
- Depression (when other treatments are ineffective)
Common Side Effects:
- Dizziness
- Nausea
- Drowsiness
- Dry mouth
- Low blood pressure
- Weight gain
- Stomach pain
- Sexual dysfunction
MAOIs can cause dangerously high blood pressure when combined with foods containing tyramine, such as aged cheeses and cured meats.
SSRIs: Mechanism, Uses, and Side Effects
Selective serotonin reuptake inhibitors (SSRIs) are among the most frequently prescribed antidepressants. They work by increasing serotonin levels in the brain, which helps regulate mood.
Common SSRIs:
- Sertraline (Zoloft)
- Fluoxetine (Prozac)
- Escitalopram (Lexapro)
- Citalopram (Celexa)
- Paroxetine (Paxil)
Conditions Treated:
- Generalized anxiety disorder (GAD)
- Major depressive disorder (MDD)
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Social anxiety disorder
Common Side Effects:
- Nausea
- Headaches
- Dizziness
- Difficulty sleeping or insomnia
- Fatigue or weakness
- Diarrhea
- Dry mouth
- Sexual dysfunction (e.g., reduced libido, difficulty achieving orgasm)
- Increased appetite and potential weight gain
SSRIs are particularly associated with sexual side effects, which may persist for some individuals.
SARIs: Antidepressants for Depression and Sleep Issues
Serotonin antagonist and reuptake inhibitors (SARIs) are often prescribed for depression and anxiety, particularly when insomnia is a concern.
Common SARIs:
- Trazodone (Oleptro)
Common Side Effects:
- Nausea
- Dizziness
- Headaches
- Fatigue
- Dry mouth
- Drowsiness
SARIs are frequently used for individuals with depression and sleep disturbances due to their sedative properties.
Atypical Antidepressants: Unique Options for Treatment
Atypical antidepressants do not fit into the main categories and work in unique ways.
Common Atypical Antidepressants:
-
Mirtazapine (Remeron)
Increases norepinephrine and serotonin.
Common side effects: Drowsiness, weight gain, increased appetite, and dry mouth. -
Bupropion (Wellbutrin)
Increases norepinephrine and dopamine.
Common side effects: Insomnia, headaches, weight loss, dry mouth, and anxiety.
Less likely to cause sexual dysfunction. -
Vortioxetine (Trintellix)
Affects serotonin in multiple ways.
Common side effects: Nausea, diarrhea, constipation, and sexual dysfunction. -
Vilazodone (Viibryd)
Increases serotonin levels.
Common side effects: Diarrhea, nausea, dizziness, and trouble sleeping.
Comparing Side Effects
| Side Effect | TCAs | SSRIs | SNRIs | MAOIs | SARIs | Mirtazapine | Bupropion | Vilazodone | Vortioxetine |
|---|---|---|---|---|---|---|---|---|---|
| Headache | X | X | X | X | X | X | X | X | |
| Diarrhea | X | X | X | ||||||
| Dry Mouth | X | X | X | X | X | X | X | X | X |
| Fatigue | X | X | X | X | X | ||||
| Sexual Dysfunction | X | X | X | X | X | X | X |
Key Takeaways
Antidepressants are effective tools for managing depression and anxiety, but they come with potential side effects that vary by type and individual response. Collaborating closely with your healthcare provider is essential to finding the right medication and dosage for your needs.
If you experience severe or unusual side effects, consult your doctor immediately. With proper guidance, you can manage side effects and work toward better mental health.