Antidepressants: key facts
Antidepressants are drugs that relieve the symptoms of
depression.
There are almost thirty antidepressants available today and
there are four main types:
- SSRIs (Selective serotonin reuptake
inhibitors)
- SNRIs (serotonin and noradrenaline
reuptake inhibitors)
- Tricyclics
- MAOIs (Monoamine oxidase
inhibitors)
Tricyclics and MAOIs are used less
often. You can find more information about these in our main leaflet.
Antidepressants can be used
for:
How well do they work?
After three months of treatment, 5-6 out of 10
people with moderately severe depression will be much improved.
This compares with the 2-3 out of 10 people who will be helped by
inactive 'dummy pill' or placebo.
What are the side effects of
antidepressants?
During the first couple of weeks, they can
make you feel sick and more anxious. They can
cause indigestion, but you can usually stop this by taking
them with food. They can interfere with your sexual
function.
These have similar side effects are similar to
the SSRIs. Venlafaxine can increase your blood pressure, so
this should be monitored regularly.
This may all sound worrying, but most people
only get mild side-effects which wear off over a couple of
weeks.
What about driving or operating
machinery?
Some antidepressants make you sleepy and slow
down your reactions. The tricyclics are more likely to do this.
Remember, depression itself will interfere with your concentration
and make it more likely that you will have an accident. If in
doubt, check with your doctor.
Are antidepressants addictive?
Antidepressants are not addictive like
tranquillisers, alcohol or nicotine. You don't need to keep
increasing the dose for them to work and you don't find yourself
craving them.
But, one third of people who
stop SSRIs and SNRIs can get withdrawal symptoms.
These include stomach upsets, flu like symptoms, anxiety,
dizziness, vivid dreams at night or sensations in the body that
feel like electric shocks.
In most people, these withdrawal effects are
mild, but for some they can be quite a problem. It is best to
reduce the dose gradually rather than stop it suddenly.
What about feelings of suicide?
There is evidence of increased suicidal
thoughts (although not actual suicidal acts) in younger people
taking SSRIs. So,SSRIs are not licensed in the UK for use in people
under 18, although specialists may use Fluoxetine in some
cases.
There is no clear evidence of an increased
risk of self-harm and suicidal thoughts in adults – but individuals
mature at different rates. Young adults are more likely to commit
suicide than older adults, so a young adult needs close monitoring
if he or she takes an antidepressant.
How long will I have to take them for?
Antidepressants don't necessarily treat the
cause of the depression or take it away completely. If you stop the
medication too soon, the symptoms of depression are more likely to
come back. It is best to take antidepressants for at least
six months after you start to recover. During this time, it is
worth thinking about what might have triggered off your depression
and ways to prevent it happening again. If you have had two or more
attacks of depression then you should take an antidepressant for at
least two years.
What if the depression comes back?
Some people have repeated depressions
and need to take antidepressants for several years to control
them. Sometimes other drugs such as lithium may be used.
Psychotherapy can help alongside to the tablets.
What other treatments for depression are
available?
How do these other treatments compare with
antidepressants?
Talking treatments are best of the depression
is mild. Over a period of a year, many talking treatments are as
effective as antidepressants in moderate depression. It is
generally accepted that antidepressants work faster.
Antidepressants and psychotherapy can be combined.
For more in-depth
information see our main leaflet.
This leaflet is made available through the
generosity of the Charitable
Monies Allocation Committee of the mental health charity St
Andrew's, Northampton
© November 2012. Due for
review: November 2014. Royal
College of Psychiatrists. You can link to, download,
print, photocopy and distribute this leaflet free of charge. But
you must not change it or repost it on a website.
Please note that we are unable to offer advice on individual cases. Please see our
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