Side effects, those unwanted but mostly predictable responses produced by medications, are a part of every pharmacological treatment.  Antidepressants are no exception.  For the millions of people who try these medications, managing side effects is part of managing their illness.  The side effects of some of these medications can make one wonder, sometimes, if the treatment is worse than the illness, especially considering the delayed beneficial action of antidepressants. Remembering that side effects usually decrease as the beneficial effects of the medication increases is helpful.

Several classes of antidepressant medication exist.  Each class has side effects most commonly associated with it.  However, each person's reaction to an antidepressant is different, even within a given class.  A person on a particular medication may have a few mild side effects while another finds that medication intolerable.

Tricyclics are one of the oldest classes of medications.  At one time a doctor's front line treatment, now they are less frequently prescribed because they may have more side effects and are much easier with which to commit suicide.  Tricyclics likely work by preventing the cells which secrete neurotransmitters from reabsorbing them.  Most common side effects suffered from tricyclics include: dry mouth, constipation, blurred vision, lowered blood pressure, weight gain and sexual difficulties. A small number of people may also experience sweating, racing heart, low blood pressure, allergic skin reactions and sun sensitivity.  However, if one has difficulty breathing, a fever with increased sweating, high or low blood pressure, loss of bladder control, severe muscle stiffness, weakness or any other unusual symptom one must call the prescribing doctor immediately.

MAOIs have been around as long as tricyclics.  They are not used frequently because food interactions can cause dangerously high blood pressure.  MAOIs are thought to work by preventing the breakdown of several neurotransmitters.  Due to their effectiveness, they are particularly good for treating atypical depression.  Side effects a person on MAOI can expect include: low blood pressure and dizziness shortly after standing, sleep disturbances, weight gain, sexual difficulties and rapid increase in blood pressure associated with eating certain foods or taking certain medication. Blood pressure rise may cause a throbbing headache beginning in the back of the head.  MAOIs may interact with over-the-counter medications, so consult a doctor to find out what is safe to ingest.  If one experiences a severe headache, palpitations, difficulty breathing, constriction  in one's throat or chest, dizziness, nausea, neck stiffness or any other unusual symptoms, one must contact a doctor immediately.

Newer antidepressants generally may have fewer side effects and are usually preferred by doctors and patients alike.  Researches think them to work in a variety of ways.  They do have general side effects, not unlike other classes of antidepressants, which include: nervousness, dry mouth, insomnia, diarrhea and headache.  If while taking an SSRI, one experiences nausea, agitation, restlessness, hypomania or other unusual symptoms, call a doctor immediately.

What can I do?

Knowing when a side effect is just an aspect of your treatment you need to learn to deal with or if you can hope for a better side effect profile with a different drug is difficult.  You must weigh negative responses against therapeutic effects.  Being on a medication that causes dry mouth may be acceptable if it works well. Work with your doctor to determine reasonable expectations for your course of treatment.

Always inform your doctor about any side effects you experience.  He may be able to help alleviate them.  Dietary changes may lessen some undesirable, inconvenient side effects caused by antidepressants.  The addition of an over-the-counter of prescription medication may help with more severe responses.  Your doctor may suggest trying a lower dosage of your particular medication or suggest a different one altogether.

Keep several things in mind when you are first prescribed antidepressants, change your medication, or add a new medication to your regime (antidepressant or other). Discuss possible side effects with your doctor.  Your doctor may be able to suggest acceptable counteractions you can take if common side effects occur.  You may only need a short term remedy for an uncomfortable situation.  If you have been prescribed a new medication by someone other than your psychiatrist, make sure you inform your psychiatrist.  This can help avoid potential problems. It is not reasonable to expect to be side effect free.  However, most people can find a course of treatment which is comfortable and effective.