Antidepressants: key facts
Under Review April 2018
Everyone has days when they feel low, but when these symptoms
persist and impact on someone's life, then antidepressants are used
to relieve the symptoms. They are used for:
Types of antidepressants
There are four types that may be prescribed:
- SSRIs (Selective serotonin reuptake
most commonly prescribed
- SNRIs (Serotonin and noradrenaline reuptake
most commonly prescribed
- MAOIs (Monoamine oxidase inhibitors)
You can find more information about these in our main leaflet.
How does it feel to take antidepressants?
Overall: After three months of treatment, 5-6
out of 10 people with depression will feel much improved.
Side effects of antidepressants?
Most people only get mild side-effects which
wear off over a couple of weeks, but you should be aware of
SSRIs and SNRIs: for
the first couple of weeks, they can make you feel sick
and anxious. This can cause indigestion, but this
improves if you eat. They can also cause diarrhoea, constipation
and tiredness. They can interfere with your sexual
Venlafaxine is an SNRI and it can increase your blood pressure,
so this should be monitored regularly.
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
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. These withdrawal effects are usually
mild, but for some people they can be quite a problem.
It is best to reduce the dose gradually rather
than stop it suddenly.
What about driving or operating
Some antidepressants (especially the
tricyclics) make you sleepy and slow down your
reactions. 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.
Do people experience feelings of
Evidence suggests that young people who
take SSRIs have increased suicidal thoughts (but not actual
suicidal acts). Therefore, in the UK, SSRIs are not licensed for
people under 18, although specialists may use Fluoxetine in some
There is no clear evidence that adults have
an increased risk of self-harm and suicidal thoughts if they
take antidepressants. It is known that younger adults are more
likely to commit suicide than older adults, so a young adult needs
close monitoring if they take 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
- Talking treatments are best for mild
depression. Over a year, many talking treatments are as affective
as antidepressants in moderate depression. However, antidepressants
and psychotherapy (talking treatment) are often used
together. Some talking treatments are now available in book
form or as Internet modules.
- St John’s Wort:
- Light boxes for seasonal affective disorder.
For more in-depth information see our main
This leaflet reflects the most up-to-date
evidence at the time of writing.
Produced by the RCPsych Public Education
Series Editor: Dr Philip Timms
Reviewed by Dr Sophie Swinhoe
Under Review April 2018 Royal
College of Psychiatrists.
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