Antidepressants have different side-effects in different people. Older medications may cause dry mouth and sedation, while newer ones may decrease sexual desire.

Side effects of antidepressant medications.

Antidepressants may cause mild, and often temporary, side effects in some people. These are usually not serious. Any reactions or side effects that are unusual, annoying, or that interfere with functioning should be reported to your provider immediately.

Tricyclic antidepressant side effectsinclude:

• Dry mouth it is helpful to drink sips of water; chew sugarless gum; brush teeth daily.
• Constipation Bran cereals, prunes, fruit, and vegetables should be in the diet.
• Bladder problems Emptying the bladder completely may be difficult, and the urine stream may not be as strong as usual. Older men with enlarged prostate conditions may be at particular risk for this problem. The doctor should be notified if there is any pain.
• Sexual problems Sexual functioning may be impaired; if this is worrisome, it should be discussed with the doctor.
• Blurred vision This is usually temporary and will not necessitate new glasses. Glaucoma patients should report any change in vision to the doctor.
• Dizziness Rising from the bed or chair slowly is helpful.
• Drowsiness during the day This usually passes soon. A person who feels drowsy or sedated should not drive or operate heavy equipment. The more sedating antidepressants are generally taken at bedtime to help sleep and to minimize daytime drowsiness.
• Increased heart rate Pulse rate is often elevated. Older patients should have an electrocardiogram (EKG) before beginning tricyclic treatment.

Side-effects of newer antidepressants including SSRIs, include:

• Sexual problems These are fairly common, but reversible, in both men and women. The doctor should be consulted if the problem is persistent or worrisome.
• Headache This will usually go away after a short time.
• Nausea This may occur after a dose, but it will disappear quickly.
• Nervousness and insomnia (trouble falling asleep or waking often during the night) These may occur during the first few weeks; dosage reductions or time will usually resolve them.
• Agitation (feeling jittery) If this happens for the first time after the drug is taken and is more than temporary, the doctor should be notified.

Any of these side effects may be amplified when an SSRI is combined with other medications that affect serotonin. In the most extreme cases, such a combination of medications (e.g., an SSRI and an MAOI or an SSRI and tramadol (Ultram)) may result in a potentially serious or even fatal "serotonin syndrome," characterized by fever, confusion, muscle rigidity, and cardiac, liver, or kidney problems.

MAOIs are not used frequently. The few people people for whom MAOIs are the best treatment need to avoid taking decongestants and consuming certain foods that contain high levels of tyramine, such as many cheeses, wines, and pickles. The interaction of tyramine with MAOIs can bring on a sharp increase in blood pressure that can lead to a stroke. The doctor should furnish a complete list of prohibited foods that the individual should carry at all times. Other forms of antidepressants require no food restrictions. MAOIs also should not be combined with other antidepressants, especially SSRIs, due to the risk of serotonin syndrome.

Medications of any kind (whether prescribed, over-the-counter, or herbal supplements) should never be mixed without consulting your provider. Never borrow medications from another person. Always tell other health professionals what medications you are taking. Some drugs are safe when taken alone but can cause dangerous side effects if taken with other drugs or with alcohol. Alcohol or street drugs, may reduce the effectiveness of antidepressants. Their use should be minimized or avoided by anyone taking antidepressants. Some people who have not had a problem with alcohol use may be permitted by their doctor to use a modest amount of alcohol while taking one of the newer antidepressants. The potency of alcohol may be increased by medications since both are metabolized by the liver - one drink may feel like two.

Some people have experienced withdrawal symptoms when stopping an antidepressant too abruptly. Therefore, when discontinuing an antidepressant, gradual withdrawal is generally advisable. Be sure to discuss any changes in medications with your provider, and ask any questions that you have. This is your most important source of information about your medications.

Source: National Institutes of Mental Health articles on antidepressant medications