6 Common Antidepressant Side Effects and How to Cope With Them

Starting antidepressants can be an important step in managing major depressive disorder (MDD), but finding the right medication is sometimes a bumpy road. One reason is that antidepressants can cause unpleasant side effects.

“Antidepressant side effects are common, but luckily many side effects are temporary and go away with continued use of the drug,” says David Merrill, MD, PhD, an adult and geriatric psychiatrist and the director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, California.

Here are six common side effects that people on antidepressants are likely to encounter — and how experts recommend you deal with each one.

1. Weight Gain or Loss Due to Appetite Changes

• Focus on eating nutritious foods like fruits and vegetables, and limit your consumption of saturated fats, trans fats, sweets, and sugar-sweetened drinks.
• Work with a registered dietitian to come up with a nutrition plan that works for your specific health needs.
• Exercise regularly to maintain or reach a healthy weight.
• Ask your doctor if you can switch to an antidepressant that’s less likely to cause appetite or weight changes.

2. Sexual Side Effects

Many people on antidepressants experience side effects such as a lower sex drive, erectile dysfunction, or delayed orgasms, says Peter Freed, MD, a New York City–based psychiatrist and media adviser for the Hope for Depression Research Foundation.

• Ask your doctor if you can take an antidepressant with a once-daily dose, and then try to schedule sex before taking that dose.
• Ask your doctor if you could lower the dose of your current medication or switch to an antidepressant with fewer sexual side effects, like bupropion (Wellbutrin).
• Tell your partner about the sexual side effects you’re having and work together to adjust your sexual routine accordingly.
• Ask your doctor about prescription medications like sildenafil (Viagra) that could help with erectile dysfunction.

3. Fatigue, Drowsiness, or Tiredness

To help manage these effects, prepare yourself in advance. “If possible, it's best to start a new medication when you have some down time or days off, rather than needing to be in the thick of it or under pressure to perform or meet deadlines.” suggests Dr. Merrill.

• Get some exercise, such as going on a walk or practicing yoga. Over time, regular exercise can help you feel like you have more energy.
• Arrange for someone else to drive you places if your fatigue or drowsiness is severe.
• With your doctor’s approval, try taking your antidepressants at bedtime.

4. Insomnia

• With your doctor’s approval, try taking your antidepressants in the morning.
• Avoid drinking caffeinated beverages, such as coffee, late in the day.
• Exercise — breaking a sweat regularly can help you sleep better over time. Just be sure to exercise several hours before you go to sleep, because doing so too close to bedtime can have the opposite effect and keep you up late.

5. Upset Stomach

When you first start taking certain types of antidepressants, such as SSRIs, they can lead to an upset stomach, with symptoms ranging from nausea to diarrhea to constipation.

“The SSRIs can activate the cells in the gut when starting the drugs,” Merrill adds.

• For nausea, it may help to take your medicine with food or before or after eating, depending on when you feel most nauseated.
• For constipation, try eating more fruits, vegetables, and fiber each day.
• For diarrhea, try eating fewer fiber-rich foods, like fruits and vegetables, than you’re currently eating.

6. New or Worsening Anxiety

• Exercise regularly — frequent physical activity is known to decrease anxiety.
• Try deep-breathing exercises, such as yoga or muscle relaxation, to help calm your mind.
• If you’re having trouble managing your anxiety, contact your doctor and ask for help.

What to Do if Your Side Effects Persist

If you’ve recently started an antidepressant and you’re experiencing side effects, it’s understandable if you feel uncomfortable or even fed up with not feeling better.

Oftentimes, your body just needs time to adjust to the antidepressant, which is why it’s important that you give your medication enough time to work, says Merrill.

• Ask your doctor to adjust the dose of your antidepressant — or even start your antidepressant at a lower dose. “We can start with a lower than usual dose to avoid initiation side effects, then slowly increase the dose gradually over the ensuing weeks,” says Merrill.
• See if your doctor could switch your antidepressant. Finding the right antidepressant is often a trial-and-error process. Some antidepressants may be less likely to cause certain side effects for you than others. For instance, as mentioned earlier, bupropion is less likely to cause sexual side effects than many other antidepressants.
• Tell your doctor if you’d like to stop antidepressants altogether. After weighing the pros and cons of stopping antidepressants in favor of another treatment option, your doctor can help you safely taper off the medication over a few weeks.

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  “Except in rare cases where the patient’s life is in danger, the doctor should be a ‘guide on the side,’ who helps the client make the decision that is right for them,” Dr. Freed says.