Key takeaways

  • Antidepressants balance brain chemicals called neurotransmitters to ease depression symptoms, with several classes available, including SSRIs, SNRIs, and MAOIs.
  • Side effects vary among antidepressants, but may include nausea, insomnia, or more serious risks like serotonin syndrome and suicidal thoughts, necessitating close monitoring by a healthcare professional.
  • Finding the right antidepressant may involve trial and error, considering factors like overall health, potential side effects, medication costs, and the frequency of doses.

Each drug used to treat depression works by balancing certain chemicals in your brain called neurotransmitters. These drugs work in slightly different ways to ease your depression symptoms.

Many common drugs for depression fall into the following drug classes:

  • selective serotonin reuptake inhibitors (SSRIs)
  • serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • tricyclic antidepressants (TCAs)
  • tetracyclic antidepressants
  • monoamine oxidase inhibitors (MAOIs)
  • noradrenergic antagonists

Atypical antidepressants, which don’t fall into these drug classes, are also available.

SSRIs are the most commonly prescribed antidepressant class to treat depression. An imbalance of serotonin may play a role in depression, and these drugs relieve depression symptoms by decreasing serotonin reuptake in your brain. This effect leaves more serotonin available to work in your brain.

SSRIs include:

Common side effects of SSRIs include:

SNRIs help improve serotonin and norepinephrine levels in your brain, which may reduce depression symptoms. These drugs include:

In addition to treating depression, duloxetine may also relieve pain. This is important because chronic pain can lead to depression or make it worse. In some cases, people with depression become more aware of aches and pains.

Common side effects of SNRIs include:

Doctors may prescribe TCAs when SSRIs or other antidepressants don’t work. They help increase levels of neurotransmitters like norepinephrine and serotonin in the brain.

TCAs include:

Common side effects of TCAs can include:

In rare cases, these drugs may cause serious side effects, such as:

Tetracyclic antidepressants like mirtazapine (Remeron) are used to treat depression and anxiety. They also work by balancing neurotransmitters to ease symptoms of depression.

Common side effects of this drug include:

  • drowsiness
  • weakness
  • lightheadedness
  • headache
  • blurry vision
  • dry mouth

MAOIs are older drugs that treat depression. They work by stopping the breakdown of norepinephrine, dopamine, and serotonin.

They’re more difficult for people to take than most antidepressants because they interact with many prescription drugs, nonprescription drugs, and some foods. They also can’t be combined with stimulants or other antidepressants.

MAOIs include:

  • isocarboxazid (Marplan)
  • phenelzine (Nardil)
  • selegiline (Zelapar, Emsam)
  • tranylcypromine (Parnate)

MAOIs can also have many side effects. These can include:

  • nausea
  • dizziness
  • drowsiness
  • trouble sleeping
  • restlessness

Other depression drugs don’t fall into the typical classes. Depending on your condition, your doctor may prescribe one of these atypical antidepressants instead:

  • nefazodone (generic)
  • trazodone (Raldesy)
  • vortioxetine (Trintellix)
  • bupropion (Wellbutrin SR or XL)
  • a combination of olanzapine (Zyprexa) and fluoxetine

Your doctor can help you understand whether an alternative drug treatment is a good choice for you.

Apart from common side effects, some antidepressants may cause more serious health complications, such as:

  • Serotonin syndrome: Serotonin syndrome occurs when serotonin levels are too high, usually because of combining antidepressants that raise serotonin levels. Symptoms include confusion, muscle twitching, seizures, irregular heartbeat, or unconsciousness.
  • Hyponatremia: Hyponatremia (low blood sodium) is a dangerous drop in salt levels in the body, usually experienced by older adults taking antidepressants. Symptoms include headache, muscle pain, disorientation, agitation, or seizures.
  • Suicidal thoughts: Some people, particularly younger people, may think about self-harm when they first start taking antidepressants. Help is available from your doctor, crisis line, or nearest emergency room.

These health risks happen less frequently than the milder side effects of antidepressants. They are all serious conditions for which you can get support from a doctor or mental health professional.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

Antidepressants are commonly prescribed for a number of medical diagnoses, including:

They can also be used off-label — meaning they’re not approved by the Food and Drug Administration (FDA) for a specific purpose — for certain conditions, such as:

Your doctor can give you more information about the antidepressant they’ve prescribed, including whether it’s an off-label use.

It can take time to find the right antidepressant for you. Each person experiences depression a bit differently, so there is no “one-size-fits-all” medication.

You can work with your doctor to find an effective and easy-to-take medication. Some factors to consider include:

  • Your overall health: Some antidepressants can negatively affect other aspects of your physical or mental health, so your doctor will review preexisting conditions and other health factors.
  • Other medications: Antidepressants can interact with other prescription medications.
  • Side effects: Depression medication can cause side effects that may be difficult to manage.
  • Prescription cost: Affordability of medication and insurance coverage is a factor for many people.
  • Frequency of dose: An antidepressant works best when you take it on a regular schedule as prescribed. If this is a challenge, it may be something to consider with your doctor when choosing an antidepressant.

You may have to take a medication for a few weeks before you start to feel the full effects.

Some people choose to switch medications or stop taking an antidepressant. Your doctor can help you make these changes, so talk with them if you feel the drug isn’t working for you. If you stop your antidepressant suddenly, it can cause serious side effects.

When it comes to treating depression, what works for one person may not work for another. Finding the right drug for your depression can take time.

If you start taking medication for your depression, it may take time to determine the therapeutic dose that works for you, and you may need to try several different medications.

Ask your doctor how long it should take for your medication to work. If your symptoms don’t improve, talk with your doctor. They may suggest another medication that may be more effective in relieving your depression.