Antidepressants and suicide risk
Some people have experienced suicidal thoughts and a desire to self-harm when they first start to take antidepressants. Those who are under 25 years of age seem to be particularly at risk.
Contact your GP, or go to hospital immediately, if you have thoughts of killing or harming yourself at any time while you are taking antidepressants.
It may be useful to tell a relative or a close friend that you have started taking antidepressants and to ask them to read the leaflet that comes with your medication. You should then ask them to tell you if they think your symptoms are getting worse, or if they are worried about changes in your behaviour.
MAOIs
Common side effects of monoamine oxidase inhibitors (MAOIs) include:
- blurred vision,
- dizziness,
- drowsiness,
- increased appetite,
- nausea,
- restlessness,
- shaking or trembling, and
- difficulty sleeping.
In rare cases, MAOIs have the potential to cause a wide range of other side effects. You should check with your GP if you are concerned about any unusual symptoms that you have.
There have been cases where MAOIs have caused a dangerous rise in blood pressure. This can cause symptoms such as:
- a stiff neck,
- severe headache,
- chest pains,
- vomiting or nausea, and
- an abnormally fast heartbeat (tachycardia).
If you experience the combination of the symptoms that are listed above, seek emergency medical help immediately by dialling 999 to ask for an ambulance.
TCAs
Common side effects of tricyclic antidepressants (TCAs) include:
- dry mouth,
- constipation,
- sweating,
- problems passing urine,
- slight blurring of vision, and
- drowsiness.
The side effects should ease after 7-10 days as your body begins to get used to the medication.
However, if the side effects continue, or they become troublesome, you should inform your GP because it may be possible to switch to a different antidepressant that may suit you better.
SSRIs
Common side effects of selective serotonin reuptake inhibitors (SSRIs) include:
- nausea (feeling sick),
- low sex drive, lack of orgasm and, in men, abnormal erection or ejaculation,
- blurred vision,
- diarrhoea or constipation,
- dizziness,
- dry mouth,
- feeling agitated or shaky,
- insomnia (not sleeping well) or feeling very sleepy,
- loss of appetite (not feeling hungry),
- sweating, and
- yawning.
These side effects should improve over time. However, if they become troublesome, you should talk to your GP because you may need to switch to a different type of antidepressant.
SNRIs
The common side effects of serotonin-norepinephrine reuptake inhibitors (SNRIs) are the same as those that are associated with SSRIs (see above).
SSRIs, SNRIs and serotonin syndrome
Serotonin syndrome is an uncommon, but potentially serious, set of side effects that is linked to SSRIs and SNRIs.
Serotonin syndrome occurs when the levels of serotonin in your brain become too high. It is usually triggered when you take an SSRI or SNRI in combination with another medication (or substance) that also raises serotonin levels, such as another antidepressant or St John’s Wort.
Symptoms of mild to moderate serotonin syndrome include:
- confusion,
- agitation,
- muscle twitching,
- sweating,
- shivering, and
- diarrhoea.
If you experience the symptoms listed above, you should stop taking the medication and seek immediate advice from your GP. If this is not possible, call NHS Direct on 0845 46 47.
Symptoms of severe serotonin syndrome include:
- a very high temperature (fever) of 39.4°C (103°F) or above,
- seizures (fits),
- irregular heartbeat (arrhythmia), and
- unconsciousness.
If you experience these severe symptoms, you should dial 999 and ask for an ambulance.
