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Antidepressants 101: Pros and Cons

Curated by Claudia Shannon / Research Scientist / ishonest

Some have strong opinions about antidepressants and whether they should be taken, concerned about side effects, psychological dependence, or addiction. Yet, many people find antidepressants can help them through different phases of depression and help them better cope.

Deciding to use an antidepressant as a treatment option is a personal decision involving a collaborative effort with your doctor. Doing your research, learning more about antidepressants, and talking with your doctor can help you make a choice that is right for you.

What are antidepressants?

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Antidepressants are medications used to treat depression. They have effects on neurotransmitters, reduce the biological impact of stress on the brain, reduce neuroinflammation – inflammation in the brain or spinal cord, and increase the brain’s capacity to deal with future stress.

They don’t work immediately; it may take a few weeks for you to feel the effects. There are different kinds of antidepressants, and you might have to try more than one before finding the one that is right for you.

Common classes of antidepressants used to help treat depression include:

  • selective serotonin reuptake inhibitors (SSRIs)
  • serotonin and norepinephrine reuptake inhibitors (SNRIs)
  • tricyclic antidepressants
  • dopamine reuptake blocker
  • 5-HT1A receptor antagonists
  • 5-HT2 receptor antagonists
  • 5HT-3 receptor antagonists
  • monoamine oxidase inhibitors (MAOIs)
  • noradrenergic antagonist

There are also atypical antidepressants, as well as natural supplements that may help boost the therapeutic effects of antidepressants.

Advantages of taking antidepressants

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There are many benefits to taking antidepressants. Being aware of these benefits can help you make an informed decision.

They are effective at relieving symptoms

Antidepressants have been found to be more effective than placebo in treating major depression in adults, though they usaully take a few weeks to reach their full effect, and you might have to try more than one to find the most effective antidepressant for you.

They are well-studied and generally safe

Antidepressants have all been approved by the Food and Drug Administration (FDA). This means they have gone through rigorous testing and clinical trials.

They can help you succeed with other parts of your treatment plan

Your treatment plan can involve a variety of things, including things like performing basic self-care tasks. If your depression makes you apathetic and lethargic, antidepressants can help restore your energy so you can do everyday activities, participate in therapy, and other items on your treatment plan.

Improved quality of life
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In addition to mood benefits, people on antidepressants report an improved quality of life: they are less reactive to negative life events, they can examine things in a more balanced way, and they can concentrate better.

Potential disadvantages of antidepressants

As with any medication, there can be cons to taking antidepressants. These may be different for each person, but being aware of them can help you prepare. Talking with your doctor about any of the drawbacks can help you reassess your medication. In this discussion, the cons must be compared with the pros.

You may need to try several to find the right one for you

Not every antidepressant will work for every person. You might have to switch more than once to find the best medication for you and your symptoms.

They may affect your sex drive

Antidepressants may reduce your sex drive or sexual functioning. Some antidepressants are more likely than others to have sexual side effects. About 1 in 5 adults in the US experiences sexual side effects due to antidepressants. This can include delayed lubrication, delayed or blocked orgasm, or trouble maintaining an erection. If the side effects are interfering with your relationship, ask your doctor about adjusting the dosage, or finding other ways to manage these side effects.

They can affect your sleep and/or your weight
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Although disrupted sleep is a common complaint of people with depression, it is not usually clear whether it is a side effect of medication or a residual symptom of depression. Overall, antidepressants may help normalize sleep over time. However, depending on the antidepressant, the dosage, and when you take it, antidepressants may contribute to insomnia, while others may be too sedating. If you have a sleep disorder, this can further affect sleep. If your antidepressant is interfering with sleep, talk with your doctor. The drug or dosage may need to be reviewed.

Some antidepressants list weight gain as a side effect. Everyone is different and responds to medications differently. Sometimes the reason for weight gain is because daily activities like making meals or going out with friends are occurring again and involve food. An improved mood can increase your appetite as well. Other antidepressants carry a lower risk of weight gain. As a whole, the potential for weight gain should not be a factor in your decision about antidepressants.

They may have side effects

Side effects can be annoying, especially at first, like dry mouth, fatigue, nausea, or headache. The good news is that these minor side effects tend to pass within a few weeks. If you continue to have side effects or there are other significant side effects that don’t go away, talk with your doctor.

If you choose to stop, you can’t stop abruptly

If you decide to stop taking antidepressants, abrupt stopping is not recommended, as withdrawal symptoms can occur. Don’t stop taking your medication until you’ve talked with your doctor. They might put you on a tapering plan or switch you to a new medication. They can also monitor you for any withdrawal symptoms.

The bottom line

Antidepressants are generally a safe and effective treatment option for depression. There are various classes of antidepressants, and different drugs within each class. Finding the right one for you can take time, and you might have to try more than one before you find the medication that works best for you.

Read more on: depression

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