Antidepressants: Get tips to cope with side effects

Most antidepressant side effects aren't dangerous, but they can be bothersome. Here's what to do.

By Mayo Clinic Staff


Antidepressants can cause unpleasant side effects. Signs and symptoms such as nausea, weight gain or sleep problems can be common initially. For many people, these improve within weeks of starting an antidepressant. In some cases, however, antidepressants cause side effects that don't go away.

Talk to your doctor or mental health professional about any side effects you're having. For some antidepressants, monitoring blood levels may help determine the range of effectiveness and to what extent dosage can be adjusted to help reduce side effects. Rarely, antidepressants can cause serious side effects that need to be treated right away.

If side effects seem intolerable, you may be tempted to stop taking an antidepressant or to reduce your dose on your own. Don't do it. Your symptoms may return, and stopping your antidepressant suddenly may cause withdrawal-like symptoms. Talk with your doctor to help identify the best options for your specific needs.


Nausea typically begins early after starting an antidepressant. It may go away after your body adjusts to the medication.

Consider these strategies:

  • Take your antidepressant with food, unless otherwise directed.
  • Eat smaller, more-frequent meals.
  • Suck on sugarless hard candy.
  • Drink plenty of fluids, such as cool water. Try an antacid or bismuth subsalicylate (Pepto-Bismol).

Increased appetite, weight gain

You may gain weight because of fluid retention or lack of physical activity, or because you have a better appetite when your depression symptoms ease up. Some antidepressants are more likely to cause weight gain than others. If you're concerned about weight gain, ask your doctor if this is a likely side effect of the antidepressant being prescribed and discuss ways to address this issue.

Consider these strategies:

  • Cut back on sweets and sugary drinks.
  • Seek advice from a registered dietitian.

Fatigue, drowsiness


Consider these strategies:

  • Take a brief nap during the day.
  • Get some physical activity, such as walking.
  • Avoid driving or operating dangerous machinery until the fatigue passes.
  • Take your antidepressant at bedtime if your doctor approves.


Some antidepressants may cause insomnia, making it difficult to get to sleep or stay asleep, so you may be tired during the day.

Consider these strategies:

  • Take your antidepressant in the morning if your doctor approves.
  • If insomnia is an ongoing problem, ask your doctor about taking a sedating medication at bedtime or ask whether taking a low dose of a sedating antidepressant such as trazodone or mirtazapine (Remeron) before bed might help.

Dry mouth

Dry mouth is a common side effect of many antidepressants.

Consider these strategies:

  • Sip water regularly or suck on ice chips.
  • Chew sugarless gum or suck on sugarless hard candy.
  • Avoid tobacco, alcohol and caffeinated beverages because they can make your mouth drier.
  • Breathe through your nose, not your mouth.
  • Talk to your doctor or dentist about over-the-counter or prescription medications for dry mouth.
  • If dry mouth continues to be extremely bothersome despite the efforts above, ask your doctor the pros and cons of reducing the dosage of the antidepressant.



Consider these strategies:

  • Drink plenty of water.
  • Get regular exercise.
  • Take a fiber supplement (Citrucel, Metamucil, others).
  • Ask your doctor for advice on stool softeners if other measures don't work.



Consider these strategies:

  • Rise slowly from sitting to standing positions.
  • Use handrails, canes or other sturdy items for support.
  • Avoid driving or operating machinery.
  • Avoid caffeine, tobacco and alcohol.
  • Drink plenty of fluids.
  • Take your antidepressant at bedtime if your doctor approves.

Agitation, restlessness, anxiety


Consider these strategies:

  • Practice deep-breathing exercises, muscle relaxation or yoga.


Sexual side effects

Many antidepressants cause sexual side effects. They can include reduced sex drive and difficulty reaching orgasm. Some antidepressants may cause trouble getting or keeping an erection (erectile dysfunction). Selective serotonin reuptake inhibitors (SSRIs) are more likely to cause sexual side effects than other antidepressants are.

Consider these strategies:

  • Talk to your doctor about switching to an antidepressant that may have fewer of these effects, such as bupropion (Wellbutrin, SR, Wellbutrin XL, others), or adjusting your medication to ease sexual side effects.
  • Talk with your doctor about options for medications, such as sildenafil (Viagra), that may temporarily ease sexual side effects or treat erectile dysfunction and any associated risks. Avoid over-the-counter herbal supplements that promise increased sexual desire and function — these are not regulated by the Food and Drug Administration (FDA) and some could be dangerous to your health.

Heart-related effects

Depending on your heart health and the type of antidepressant you take, you may need an electrocardiogram (ECG) before or periodically during treatment. The ECG is used to monitor what's called the QT interval to make sure it's not prolonged. A prolonged QT interval is a heart rhythm condition that can increase your risk of serious irregular heart rhythms (arrhythmias).

Certain antidepressants should not be used if you already have heart problems or if you're taking an MAOI. Talk with your doctor about your heart health and any heart medications or other medications that you take.

Genetic variations

Some studies indicate that variations in genes may play a role in the effectiveness and risk of side effects of specific antidepressants. So your genes may, at least in part, determine whether a certain antidepressant will work well for you and whether you're likely to have certain side effects.

Some locations already provide limited genetic testing to help determine antidepressant choice, but testing is not routine and it's not always covered by insurance.

More studies are being done to determine what might be the best antidepressant choice based on genetic makeup. However, genetic testing is a part of — not a replacement for — a thorough psychiatric exam and clinical decisions.

Sept. 12, 2019 See more In-depth

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