Are antidepressants safe? Will I become addicted to depression medication? Get expert answers to common questions about depression treatment.
There’s no doubt that the use of antidepressants is on the rise — roughly 67 percent of people with major depression use medications as their primary form of treatment, says the National Alliance on Mental Illness (NAMI).
Yet despite this popularity, taking antidepressant drugs isn’t without risks and can lead to a lot of questions about safety and use. That’s why it’s essential to work with your doctor to make a well-informed decision about depression medication and to remain knowledgeable as you stay the course.
Types of Antidepressants
The two classes of drugs most commonly prescribed for depression are selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), says Rajnish Mago, MD, director of the mood disorders program and an associate professor of psychiatry and human behavior at Thomas Jefferson University in Philadelphia. These medications work on the brain chemicals serotonin and norepinephrine, according to the National Institute of Mental Health. Another common antidepressant drug affects the chemical dopamine in the brain.
Tricyclics and monoamine oxidase inhibitors (MAOIs), two older classes of antidepressants, usually aren’t prescribed as first-line treatment.
FAQs About Depression Medication
Here are some of the questions psychiatrists hear most often about depression medication. Use these as a launching pad to starting a conversation with your own doctor.
Q: Are there side effects of antidepressant drugs?
A: Short-term side effects may develop during the first two weeks of taking an antidepressant drug, including headaches, nausea, hand tremors, and insomnia. If you experience any of these symptoms, remember that they’re temporary. Call your doctor and explain what’s happening, Dr. Mago says. There may also be long-term side effects such as weight gain, low libido, and fatigue that can be associated with taking SSRIs and SNRIs.
Antidepressant medication should only be taken if the benefits outweigh the risks, so be sure to tell your doctor what you’re experiencing. If side effects are intolerable, he or she may change your medication.
Q: Will depression get worse before it gets better?
A: Some people may feel that their depression symptoms worsen at first because of the initial side effects and because it can take two to six weeks for the medication to take full effect. Keep in mind that things will get better, Mago says.
Q: Are antidepressant drugs addictive?
A: Mago often hears this question from people, and says the answer is “no.” While you’ll have to taper off an antidepressant when you’re ready to stop taking the medication to avoid a recurrent episode of depression, it’s not the same as being addicted.
Q: Will antidepressant medication change my personality?
A: Antidepressant drugs don’t change your personality per se, but they can make some people feel emotionally numb, Mago says. “Some people who take antidepressant medication say they don’t feel depressed, but they don’t feel happy, either,” he notes. It’s rare, but when this does happen, it’s usually associated with drugs that work through the brain chemical serotonin. In that case, changing to a drug that affects dopamine may help.
Q: How long will I need to take medication for depression?
A: The goal is 100 percent improvement of your depression symptoms, Mago says, which may take several months. Once you’re there, he recommends continuing the medication for another 4 to 12 months before tapering off with your doctor’s guidance.
Someone who’s had at least three episodes of major depression may need long-term preventive antidepressant treatment, which would mean taking medication for several years.
Q: What if I still experience depression symptoms?
A: If you’ve been taking antidepressant medication for longer than six weeks and you’re still depressed, you may need a higher dose or a different medication. Tell your doctor if you’re experiencing symptoms and ask if it’s time for a change.
Q: What if I skip a dose of antidepressant medication?
A: Some people wrongly believe that they should only take an antidepressant on the days they’re feeling depressed, but you should take it every day. In general, if you miss a dose, take it as soon as you remember. But some antidepressant drugs shouldn’t be taken after a certain time of day because they may cause insomnia.
Q: Can I drink alcohol with antidepressant medication?
A: The effects of alcohol on a person who’s taking an antidepressant drug will vary. “Some people may feel no difference, while others may say one drink feels like three,” Mago says. What’s more, alcohol is a depressant and can cause feelings of depression, counteracting the benefits of your medication. But if having a drink at dinner is important to you, discuss it with your doctor first. And remember to drink in moderation, don’t drive, and don’t drink alone.
Q: Are antidepressants safe during pregnancy?
A: Antidepressant drugs have been associated with preterm birth, heart abnormalities, and even autism, Mago says. Talk to your doctor if you are pregnant or trying to conceive so you can make the right treatment decisions together.
Q: Can I take a supplement with antidepressant medication?
A: Some dietary supplements should not be taken with antidepressant drugs. For example, an SSRI should never be taken with the supplement St. John’s wort because they work in similar ways, Mago says. But taking fish oil is probably okay, he says. Always ask your doctor before combining any supplements with prescription drugs.
Last Updated: 2/22/2016