Antidepressants

This article provides a comprehensive overview of the use of antidepressants, including specific types, how they work, side effects and risks, and how they are used within various treatment plans.

Key Takeaways:

• Antidepressants are used for several types of depression, as well as anxiety disorders, trauma, stress, eating disorders, and other conditions. They affect certain neurotransmitters in your brain and may positively impact general brain function.
• Antidepressants can work for many people, but they don’t work for everyone. There are also significant side effects and risks associated with antidepressant use, such as mood changes, sexual dysfunction, and potential for withdrawal symptoms.
• Antidepressants are typically used for at least 6 months, and are often combined with psychotherapy for the greatest effects. Regular check-ins and evaluations with your doctor help to formulate a treatment plan that’s best for you.

Antidepressants Explained

Antidepressants are a type of prescription medication used to treat depression and related symptoms, particularly for moderate, severe, and/or chronic cases. They can also be used for a variety of other conditions, such as anxiety disorders, sleep disorders, and eating disorders. ^[1] [2}

In general, antidepressants work by increasing the level and overall functioning of certain neurotransmitters in the brain. They are designed to help with mood, sleep, and overall mental well-being. There are several classes of antidepressants, and thus the specific effects and benefits vary depending on the exact type of antidepressant used. ^{[1] [2] [3]}

Prevalence of Antidepressant Use

Antidepressants are one of the most widely used prescription mental health medications. Their use has steadily increased in most countries over the last several years as well. Antidepressant rates have increased from approximately 5% to 6.7% (or 50 to 67 out of 1,000 individuals) on average, although this varies from country to country. ^[4]

How Do They Work?

Researchers believe that antidepressants work by increasing the production and overall function of certain neurotransmitters involved in mood and stress. The most common neurotransmitters affected by antidepressants are serotonin and norepinephrine, and, to a lesser extent, dopamine. ^{[1] [2] [3]}

However, recent evidence suggests that the neurotransmitter imbalance theory of depression only partially explains depression symptoms. There are many other roles too, such as brain inflammation, overall connectivity and functioning between brain regions, gut-brain axis function, and other factors. And some antidepressants may have positive effects here as well, such as by promoting structural and functional brain changes (known as neuroplasticity), and supporting nerve cell health. ^[1]

Conditions Treated with Antidepressants

Antidepressants are used not only to treat depression, but also anxiety disorders and several other conditions. Common conditions treated with antidepressants include: ^{[1] [2] [3]}

• Major depressive disorder (MDD)
• Persistent depressive disorder (PDD)
• Seasonal depression (seasonal affective disorder)
• Bipolar disorder (not for bipolar I due to risk of mania, but sometimes with bipolar II when paired with a mood stabilizer)
• Post-traumatic stress disorder (PTSD)
• Social anxiety disorder (SAD)
• Panic disorder
• Generalized anxiety disorder (GAD)
• Insomnia
• Eating disorders, such as bulimia nervosa and binge eating disorder

This widespread applicability is likely since these conditions all share at least some similar etiologies, such as abnormal brain function and neurotransmitter irregularities.

Types of Antidepressants

Currently, there are over 40 different antidepressants that can be prescribed in most countries. Research and treatment advances over the last few decades have led to changes in which medications are typically prescribed. Listed below are the main types of antidepressants, grouped into commonly used and less commonly used categories.

Common Antidepressants

The most commonly prescribed types of antidepressants are: ^{[1] [2] [3]}

• Selective-serotonin reuptake inhibitors (SSRIs): These are the most commonly prescribed antidepressants. They block the reuptake of serotonin, which leads to more serotonin circulating in the brain. Serotonin is important for mood, appetite, sleep, and other functions.
• Common SSRIs include sertraline, fluoxetine, and citalopram.
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): These drugs inhibit the reuptake of serotonin and norepinephrine. They are designed to have more energizing effects due to the added effects of norepinephrine.
• Common SNRIs include venlafaxine and desvenlafaxine
• Tricyclic antidepressants: These drugs inhibit the reuptake of norepinephrine and serotonin, and may also inhibit acetylcholine and histamine.
• Examples include amitriptyline, clomipramine, and doxepin

Lesser-Used Antidepressants

There are other categories of antidepressants, too, but these are typically used after other options are explored, mainly due to less overall effectiveness and/or higher likelihood of side effects. This includes: ^{[1] [3]}

• Atypical antidepressants: This is a varied group of antidepressants that may act on various neurotransmitters and hormones, such as serotonin, dopamine, norepinephrine, and melatonin.
• Examples include mirtazapine and agomelatine
• Monoamine oxidase inhibitors (MAOIs): MAOIs inhibit an enzyme that breaks down serotonin, dopamine, and norepinephrine. All three of these neurotransmitters are involved in mood regulation.
• Common MAOIs include selegiline and moclobemide
• NMDA Antagonists: These drugs bind to NMDA receptors, which prevents glutamate from binding to it. Glutamate works in concert with GABA to regulate brain activity.
• Ketamine and esketamine are the two most common ones
• Serotonin modulators: These drugs inhibit serotonin reuptake. Some offer other effects, depending on the exact drug.
• Common serotonin modulators include trazodone and nefazodone
• Selective-norepinephrine reuptake inhibitors: These inhibit the reuptake of norepinephrine only.
• One example is reboxetine

Side Effects of Antidepressants

There are several side effects to be aware of with antidepressants. Certain classes of antidepressants have a higher prevalence and severity of side effects compared to other classes. Listed below are common side effects from each class of antidepressant: ^{[1] [3] [5] [6]}

• SSRIs:
• Sexual dysfunction
• Headache
• Sleep problems
• Nausea
• Diarrhea
• QTc prolongation (a heart rhythm issue)
• Loss of appetite
• Weight loss

• SNRIs:
• Hypertension
• Headache
• Diaphoresis (excessive sweating)
• Bone resorption
• Loss of appetite
• Weight loss

• Atypical antidepressants:
• Liver toxicity
• Weight gain
• Sedation
• Seizures

• Serotonin Modulators:
• Liver toxicity
• Diarrhea
• Nausea
• Sedation

• Tricyclic antidepressants:
• Dry mouth
• Urinary retention
• Constipation
• Seizures
• Orthostatic hypotension

• MAOIs
• Sexual dysfunction

• NMDA Antagonists:
• Dissociation
• Changes in perception

Overall, the most common side effects of antidepressants are sexual dysfunction, drowsiness, insomnia, anxiety, weight gain, dizziness, dry mouth, digestive issues, and headache. ^{[1] [2]}

Side effects tend to be worse in the first 2 to 4 weeks after starting treatment and may improve over time as your body adjusts to the medication. ^[5]

Risks and Complications when Taking Antidepressants

Like any prescription medication, antidepressants are not without their risks. The more notable complications and risks to be aware of include: ^{[1] [2] [3] [7]}

• Serotonin syndrome
• Suicidal ideation
• Antidepressant discontinuation syndrome
• Liver damage and heart problems
• Overdose/toxicity
• Increased risk of falls and fractures

Serotonin Syndrome

This occurs when too much serotonin builds up in the brain. It can cause mild to severe symptoms, such as restlessness and mild gastrointestinal issues, to significant concerns, such as disorientation, rapid heart rate, and seizures. ^[1] If not addressed quickly, serotonin syndrome can be fatal.

Suicidal Ideation

Many antidepressants come with a box warning, the Food and Drug Administration’s highest warning level for prescription medications, because antidepressants may increase the risk of suicidal thoughts and behaviors, especially in children and young adults under 25. This risk is greatest when these individuals start taking an antidepressant or when the dose is changed. ^{[1] [2] [3]}

Antidepressant Discontinuation Syndrome

Some people may experience notable side effects when discontinuing their antidepressant. The side effects are most severe for individuals who stop without notifying their doctor and quit “cold turkey”, but side effects can happen even under medically guided tapering. This may lead to: ^[7]

• Anxiety
• Sleep problems
• Rapid mood changes
• Brain “zaps”
• Difficulty concentrating
• Suicidal thoughts
• Restlessness

This is not an exhaustive list, but outlines the most common issues.

Liver Damage and Heart Problems

Some antidepressants increase the risk of liver damage and heart problems. Certain types of SNRIs and serotonin modulators may cause liver toxicity or damage, while SSRIs and SNRIs can cause changes in heart rhythm. ^[1]

Overdose/Toxicity

Consuming much larger than the recommended dose of antidepressants can lead to toxicity. This can lead to several risks and effects, including: ^[1]

• Rapid heart rate
• High blood pressure
• Serotonin syndrome
• Changes in consciousness
• Seizures
• Coma
• Death
• Drowsiness
• Vomiting

How Effective are Antidepressants?

While finding the right antidepressant treatment can be complex, appropriate treatment can lead to positive results in up to 70 to 80% of individuals with MDD. However, other research has shown that taking a placebo leads to improved symptoms in roughly 30% of people, compared to improved symptoms in 50% of those who took antidepressants, which suggests a more moderate overall effectiveness. ^{[1] [2]}

In general, the more severe the depression or other symptoms, the more effective antidepressants are. ^[3]

Treatment Duration and Desired Outcomes

Total antidepressant treatment duration depends on several factors, including initial symptom severity, a person’s goals and needs, side effect burden, treatment adherence, and overall improvement. In general, antidepressants are administered for a period of 6 to 12 months, although some individuals may be treated with them for longer periods or indefinitely in cases of chronic concerns. ^{[1] [6]}

To figure out if an antidepressant is right for you, your doctor will first assess your symptoms and your medical and mental health history to get a sense of your diagnosis and potential treatment options. Your provider will recommend the type of antidepressant that may best alleviate your symptoms. In the first 2 to 3 weeks, your doctor will monitor you for side effects and tolerance.

If side effects are minimal and well-tolerated, the next step is to determine the overall effectiveness on depression, anxiety, and/or other symptoms. Some improvements should be seen within a few weeks, but the greatest typically occur after 6 weeks. Using this information, you and your doctor decide on the course of action from there.

Incorporating Therapy into Antidepressant Treatment

Many treatment plans also add psychotherapy alongside antidepressants. Research shows that combination therapy usually leads to greater benefits compared to antidepressant use alone, especially for moderate to severe depression. In fact, some research suggests psychotherapy by itself is more effective than antidepressants by themselves, further highlighting the importance of adding psychotherapy. ^{[1] [8]}

Based on these benefits, therapy and medication are typically started simultaneously. Other times, therapy may be implemented after an initial period of standalone antidepressant treatment, particularly if your symptoms aren’t improving as much as hoped. Or, therapy may lead to a recommendation for a psychiatric evaluation to see if you can benefit from medication. If you are receiving both therapy and medication, it is essential to stay consistent with both treatments to achieve the best outcomes.

Current Studies and Breakthroughs

Research is constantly advancing the way depression is treated. Over the last few years, many new antidepressants have been approved for use, and many more are currently being investigated for their potential benefits.

Some of the major recent findings regarding antidepressant breakthroughs are listed below: ^[9]

• Neurosteroids are effective for postpartum depression, and have further been shown to be helpful for depression with anxiety, and bipolar depression.
• Examples of neurosteroid medications include brexanolone and nuranolone
• The combination of dextromethorphan and bupropion (known as Auvelity) seems beneficial for depression with anxiety, and may be useful for treatment-resistant depression
• Dextromethadone may be an effective adjunct treatment for depression, as well as related symptoms, such as anxiety, social functioning, and sleep quality
• Psilocybin has been found to have rapid effects in some cases of depression, likely due to effects on brain plasticity.
• It is an option for treatment-resistant depression, and may have further benefits for mood, personality, emotions, and cognition
• Ayahuasca, a traditional psychedelic drink, may have rapid antidepressant effects in some people. However, the side effects and overall long-term safety need more study
• Botulinum may be useful for depression, with fewer side effects than sertraline and other common antidepressants
• The use of probiotics and a Mediterranean-style diet may improve depression by improving the gut-brain axis

When to Speak to a Doctor About Prescribing Antidepressants

You should speak to your doctor about prescribing antidepressants if you’re experiencing moderate to severe depression symptoms that are significantly impacting your overall well-being and ability to function. Intense sadness, trouble sleeping, significant irritability, rapid mood changes, and suicidal thoughts are all key signs that you may be suffering from depression and need appropriate treatment.

As mentioned, antidepressants can be useful for several other conditions too. Therefore, if you are experiencing symptoms of anxiety, insomnia, chronic pain, PTSD, or eating disorders, it may be beneficial to speak with your doctor about the potential role of antidepressants. It’s always better to err on the safe side and seek help even when you might not necessarily need it, rather than waiting too long and letting symptoms worsen.

Final Thoughts

Antidepressants can be a valuable treatment for depression and other mental health concerns. However, there are possible side effects, and the most effective treatment often varies greatly from person to person. Thus, it’s essential to communicate with your doctor and other members of your healthcare team, so that they can provide the most individualized treatment plan for your own needs and goals. As research continues to identify newer, less side-effect-prone medications, more people will likely be able to be treated effectively.

Antidepressant FAQs

Listed below are common questions asked about antidepressants.

Do antidepressants cause weight gain?

Antidepressants may cause weight gain in some individuals. It is one of the more common side effects. However, others may experience weight loss or no change in weight at all; individual responses vary.

Can you take antidepressants while pregnant?

Yes, certain antidepressants may be allowed during pregnancy if your doctor believes the benefits outweigh the risks. They may not be suitable in all cases. SSRIs and SNRIs are typically the ones first prescribed, and usually at the lowest possible effective dose.

Are antidepressants addictive?

Antidepressants are generally not considered addictive. Antidepressants can cause physical dependence, which can lead to withdrawal symptoms, but this is not the same as addiction. Addiction involves cravings or compulsive urges to use the substance, experiencing a “high”, and feeling like you’re losing control over your use, none of which are features of antidepressants. ^{[6] [7]}

Can you choose what type of antidepressant you are prescribed?

You can’t directly choose your antidepressant without your doctor’s input. However, you and your doctor can certainly work together to figure out which medication is best for you. That’s why it’s important to communicate with them often, especially about any side effects and how the medication is working.

Author

Jack Cincotta

Jack Cincotta holds a M.S. degree in Psychology. He is also a board-certified holistic health practitioner through AADP and an AFPA-certified holistic health coach and nutritionist.

Activity History - Last updated: March 19, 2026, Published date: March 19, 2026

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Reviewer

Geralyn DexterPhD, LMHC

Geralyn Dexter, PhD, LMHC (she/her), is a psychology faculty member, researcher, writer, and licensed therapist with 15 years of experience providing evidence-based care.

Activity History - Medically reviewed on April 9, 2026 and last checked on March 19, 2026