Antidepressants Side Effects: Long- And Short-Term Risks

Last Updated: June 3, 2020

Authored by Sharon Levy, MD, MPH

Depression medication can help people live their best lives, but antidepressant side effects can sometimes make treatment unbearable. While some common effects of antidepressants are mild and go away with time, others are long-lasting and even debilitating. Here is what people should know about the side effects of antidepressants.

Long-Term Effects Of Antidepressants

All antidepressant medications have both short-term and long-term side effects. Many of these are mild, and most go away with time. However, some of these are so severe or long-lasting that patients end up needing to stop treatment due to side effects alone.

Among the long-term side effects of antidepressants are:

  • Sexual health struggles, including struggling to achieve an erection, difficulty maintaining an erection, an inability to reach orgasm, and a lack of sexual desire
  • Weight gain, often due to depression medications increasing appetite
  • A feeling of being emotionally numb, not depressed, but not feeling other emotions either
  • A sense of not being like oneself, perhaps due to the state of depression having become normal
  • Feeling as though the medication is addictive and they cannot stop
  • Not connecting deeply with others and feeling emotionally distant
  • Struggles with regulating blood sugar and the development of type 2 diabetes
  • Feelings of being more depressed than before starting the drug, even having suicidal thoughts
  • Abnormal heart rhythm, which can result in various health problems
  • High blood pressure
  • Damage to the liver, up to and including liver failure
  • Memory loss, especially in older individuals

For those who are concerned about the side effects of antidepressants in the long-term, it is possible to be treated with options that are less likely to cause problems. Medications on an atypical antidepressants list tend to have relatively few side effects. There are also OTC antidepressants that can help people who prefer supplements to prescription drugs.

Do Antidepressants Make One Happy?

Because antidepressant side effects are meant to ease or eliminate depression, many people assume that taking these medications means feeling happy all the time. However, it is not how they work.

How long it takes antidepressants to work means that the effects of the drugs are not felt for weeks, even months after use begins. Once they do begin to work, what the patient feels is not a sense of euphoria. It is vital that users do not think of them as happiness is in a pill, as this is not what the medications deliver.

Instead, it is more like a leveling out of the mood. By reducing or eliminating the severe lows that depression produces, the average mood a person feels is more stable and closer to contentment. However, for some users, these medications do not just eliminate feelings of depression, but emotions in general. For those who experience this side effect of antidepressants, sometimes their medicated state is less desirable than going without pharmaceutical treatment.

when anridepressants result in tiredness

Why Do Antidepressants Make One Tired?

One of the most common side effects of antidepressants is drowsiness or a sensation of being tired all the time. Ultimately, there can be several reasons for this side effect to emerge. The first possibility to consider is that it is not an effect of the medication itself, but the depression it is treating. If this is the case, effective treatment will see this lethargy fade with time.

However, it is certainly possible for the drugs to cause this side effect. Out of the various classes of depression medications, TCAs are the most likely to cause significant fatigue, to the point that it can be debilitating. It is because they impact the levels of histamine in the body.

Can Antidepressants Cause Hair Loss?

One of the side effects that is not often spoken about is antidepressant hair loss. Although not well-known, it is well-documented. Certain types of depression medication are more likely to lead to hair loss than others, so those who are concerned about this negative effect of antidepressants could ask their doctor to prescribe one not associated with causing the hair to fall out.

Antidepressants And Liver Damage

One of the most devastating side effects of antidepressant use is liver damage. Unfortunately, all depression medications have the potential to cause hepatotoxicity, harming the health of the liver. In most cases, this is a long-term side effect of antidepressants and is not reversible by stopping depression treatment or taking drugs for the liver. This effect is prominent enough that as many as 5 percents of all people with liver damage have it as a result of antidepressant use.

Do Antidepressants Cause Memory Loss?

While it is not common enough for most patients to worry about it, one negative effect of antidepressants on the brain is memory loss. It is most likely to be experienced by older adults and with the use of tricyclic depression medications. The sedative effects of depression medications cause it.

Some drugs are less likely to have this side effect than others. However, all depression medications have the potential to result in some memory loss. In most cases, this goes away once the body adjusts to the medicine, and the sedation is no longer felt the way it once was. However, for some users, this antidepressant side effect will last throughout active treatment, and even after.

problems with sleep while taking antidepressants

Antidepressants And Sleep

Perhaps the most prominent side effects of antidepressants are those related to sleep. Because depression itself can disrupt sleep cycles, going from one form of disturbed sleep to another can be difficult to accept. Most patients will adjust to their medication and stop having sleep issues, but for others, they may be ongoing.

Do Antidepressants Make One Sleepy?

All antidepressants can induce feelings of sleepiness and lethargy in users. However, experiencing these side effects of antidepressants is not a guarantee. Still, anyone starting depression medication should prepare for this to occur and avoid driving or operating heavy machinery until they adjust.

Antidepressants And Insomnia

Because a side effect of depression medications is sleepiness, it stands to reason that they will at least make sleeping easier. However, it is not always true. Insomnia or otherwise disrupted sleep is one of the most common side effects of use antidepressant patients’ experience.

Why Do Antidepressants Cause Vivid Dreams?

Many people who take depression medications experience vivid dreams. For some, this is a negative effect, while for others, it is a positive side effect. These dreams occur due to how depression medications impact REM sleep. These drugs suppress the REM sleep, which results in something called rebound REM, during which vivid dreams are experienced.

Antidepressant-Induced Night Sweating

Another aspect of concern is if depression medications can cause night sweating. Ultimately, this is a negative effect of all antidepressants, but some are more prone to this than others. SSRI drugs cause night sweating more than other depression medicines. This is unfortunate, given they are the most prescribed class of depression medicines. However, this side effect tends to go away with time, and for most patients, it is not bad enough to consider stopping use.

increased depressive feeling after taking antidepressants

Can Antidepressants Make One More Depressed?

It is common for people to wonder if antidepressants cause depression. The answer to this is a bit complicated.

All depression medications have the risk of the side effect of increasing suicidal thoughts and actions in the patient. The FDA requires a black box label on all medications that treat depression. This risk is greatest in those under the age of 25 and tends to present mostly in the first few weeks of treatment.

However, it does not mean that they are making the patient more depressed or causing depression. Once the brain chemistry stabilizes, usually one to two months into treatment, these experiences less or go away completely, leaving the patient less depressed than they were initially.

But it does not mean that someone taking depression medications will not feel depressed or that treatment with them cannot make someone feel more depressed as time goes on. In fact, dealing with the side effects of antidepressants can be depressing on its own.

Taking Antidepressants When Not Depressed

At the moment, it is not yet clear what happens if one takes antidepressants when is not depressed. However, preliminary research has looked at the question and what it shows is concerning.

Sometimes people who do not have a depressive disorder or will take depression medications. This can be a result of having them prescribed for another condition, or someone might choose to take them without a doctor’s recommendation. For example, because antidepressants and weight loss can occur, some people take them as diet pills.

Coping With Antidepressant Side Effects

If someone has severe depression, treating it may be more important than not experiencing side effects, depending on what those side effects are. For individuals who wish to continue treatment despite side effects, learning how to cope with side effects is important.

The first thing the patient should do is sit down with their doctor and determine if any of their other medications could be interacting in a way that produces side effects of antidepressants. For example, antidepressants and some birth control medications can interact to increase the likelihood of weight gain. The user could switch birth control drugs and eliminate this effect.

From there, the user should look into strategies that can alleviate specific symptoms they are battling.

For nausea, they could:

  • Take their dose with a meal
  • Break up their meals into six smaller ones
  • Work to stay hydrated
  • Use ginger supplements and candies

For sexual side effects, a patient might:

  • Change to an extended-release formula that requires one dose a day, giving them a period each day with higher sex drive and better performance
  • Use medications that improve performance
  • Switch to a medication without sexual side effects

It is important to note that if a woman is using antidepressants while breastfeeding, a child may experience side effects as well. All pregnant and breastfeeding mothers should consult with their doctor about use. Additionally, users should not attempt to self-medicate to address their symptoms as it can result in an overdose on antidepressants.

When It Is Time To Stop Antidepressants

Whether someone wishes to stop using due to the negative effects of antidepressants, abuse of drugs, or just a desire to live pill-free, it is vital that the medicines are stopped safely. With a drug rehab center, withdrawal symptoms can be managed, and the medications tapered so that users feel little to no side effects. It is possible to stop antidepressant use and still live a good life.

Page Sources

  1. Brass SD, Auerbach S. A sleepy patient with REM rebound. Journal of Clinical Sleep Medicine. 2009; 5(4): 386–389.
  2. DRUG RECORD: ANTIDEPRESSANT AGENTS. National Institutes of Health. 2019.
  3. Richelson E. Tricyclic antidepressants and histamine H1 receptors. Mayo Clinic Proceedings. 1979; 54(10): 669-74.
  4. More than a happiness boost: How mood medications help when you’re depressed. Harvard health Publishing. 2016.

Published on: October 15th, 2019

Updated on: June 3rd, 2020

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.


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