13.2% of adults over 18 years old in the United States have used antidepressant medication in the past 30 days. Although this is a common method of treatment for people with Major Depressive Disorder, up to 30% of people who have been treated for MDD do not respond to at least two different antidepressant treatments. These people who are not responsive to traditional methods of treatment may be diagnosed with treatment-resistant depression (TRD).
Antidepressants can be a non-effective treatment for people with treatment-resistant depression. In others, the side effects of antidepressants can outweigh the benefits that can be associated.
Common Side Effects
Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-norepinephrine Reuptake Inhibitors (SNRIs), Tricyclic antidepressants (TCAs), Monoamine Oxidase Inhibitors (MAOIs) are all associated with side effects that can be mild to severe. All of these medications are antidepressants that are intended to help treat depression symptoms.
Common side effects of antidepressants include but are not limited to:
- anxiety
- blurred vision
- constipation
- dizziness
- dry mouth
- fatigue
- feeling numb
- insomnia
- reduced sex drive
- weight gain
Serious side effects
Serious side effects from antidepressants can cause the life of the individual who is taking them to alter drastically and dramatically. Although serious side effects do not affect everyone who takes antidepressants, knowing the side effects of antidepressants can help you decide if the risk is worth the potential benefit.
Serotonin Syndrome
Serotonin syndrome is a potentially life-threatening syndrome that happens when an individual is taking serotonergic drugs which can cause a build-up of high levels of serotonin in the body. Serotonin syndrome can range from mild to life-threatening and is often referred to as serotonin toxicity. Symptoms usually occur within 24 hours of an increased dose of a serotonergic medication, the addition of another serotonergic drug, or an overdose.
The side effects associated with this syndrome affect mental, neuromuscular hyperactivity, and autonomic hyperactivity:
- Altered mental status – agitation, anxiety, disorientation, restlessness, excitement
- Neuromuscular abnormalities – tremors, clonus, hyperreflexia, muscle rigidity, bilateral bainkski signs, akisthesia
- Autonomic hyperactivity – hypertension, tachycardia, tachypnea, hyperthermia, mydriasis, diaphoresis, dry mucous membranes, flushed skin, shivering, vomiting, diarrhea, hyperactive bowel sounds, arrhythmias
Hyponatremia
Hyponatremia is a condition where the level of sodium in the blood is too low due to antidepressants affecting the normal hormonal and kidney processes. There is an increased risk of this condition occurring in patients taking antidepressants, and the highest risk occurs within the first two weeks of treatment. Common symptoms associated with hyponatremia include nausea, fatigue, muscle cramps, and headache.
Hyponatremia has potentially dangerous side effects of antidepressants that were once thought to just include SSRIs but now has been found to be associated with other common antidepressants. This condition is also associated with more severe symptoms as it relates to your neurobiology and psychology.
The neuropsychiatric severe symptoms associated include:
- Cerebral edema
- Causing confusion
- Restlessness
- Gait abnormality
- Lethargy
- Seizures
- Coma
Suicidal Thoughts or Behaviors
Suicidal thoughts and behaviors have been included in the black box warning by the FDA on antidepressants. Suicidality risks increase in children, adolescents, and young adults with Major Depressive Disorder who take antidepressants. The FDA recommends that patients of all ages who start antidepressant therapy and medication be monitored and observed closely.
Seizures
Seizures are an uncommon but serious adverse reaction to antidepressants. Seizures are more often seen in people with previous seizures, sedative or alcohol withdrawal, and concomitant medications. Seizures become an increased risk while the dose of the antidepressant increases.
Discontinuation Syndrome
Discontinuation syndrome can occur after stopping SSRIs and SNRIs. Symptoms of this syndrome can include nausea, vertigo, trouble sleeping, odd sensory symptoms, and anxiety. Discontinuation syndrome usually occurs when an individual has been taking antidepressants for six weeks or longer.
About 1 in 5 people who abruptly stop taking their antidepressant may experience at least a mild version of these symptoms. To lessen the symptoms of discontinuation syndrome, your psychiatrist may recommend slowly stopping and tapering the medication rather than stopping abruptly.
Alternative To Antidepressants
Antidepressant side effects and effectivity may cause some individuals to veer away from antidepressants as a form of treatment for their depression. Side effects can vary in severity and can outweigh the potential benefits of these medications.
If you or a loved one have tried traditional forms of treatment for depression with no success, reach out to Clear Care Center to see if transcranial magnetic stimulation (TMS) may work for you. TMS is an FDA-approved treatment for people with Major Depressive Disorder (MDD) who have not responded to at least two forms of antidepressants. TMS is a non-invasive treatment where
