Purpose
This information explains common issues discussed when antidepressant medication is being considered for depression, anxiety, or related conditions.
It is general information only. Your psychiatrist will discuss whether antidepressant medication is appropriate for you.
What are antidepressants?
Antidepressants are medicines used to treat conditions such as:
- Depression
- Generalised anxiety disorder
- Panic disorder
- Social anxiety disorder
- Obsessive-compulsive disorder
- Post-traumatic stress symptoms
- Some chronic pain conditions
- Premenstrual mood symptoms in some cases
Different antidepressants work in different ways.
Common classes include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-noradrenaline reuptake inhibitors (SNRIs)
- Tricyclic antidepressants
- Other antidepressant medicines
Some uses of antidepressants may be off-label and are made at the treating psychiatrist's clinical discretion based on individual assessment. Choice of medicine is a clinical decision.
How can antidepressants help?
Antidepressants may help reduce:
- Low mood
- Anxiety
- Panic symptoms
- Irritability
- Rumination
- Sleep disturbance
- Loss of interest
- Emotional overwhelm
- Physical symptoms associated with anxiety or depression
They may also improve functioning and ability to engage in therapy or lifestyle changes.
How long do they take to work?
Antidepressants usually do not work immediately.
Some side effects may appear in the first few days.
Benefits often begin gradually over several weeks. Full benefit may take longer.
Your psychiatrist will explain what to expect and when to review progress.
Common side effects
Possible side effects include:
- Nausea
- Headache
- Dry mouth
- Sleepiness
- Insomnia
- Increased anxiety at the start
- Sweating
- Dizziness
- Changes in appetite
- Weight changes
- Sexual side effects
- Vivid dreams
- Fatigue
- Gastrointestinal upset
Side effects often improve with time, but not always. Tell your psychiatrist if side effects are troublesome.
Important risks and precautions
Tell your psychiatrist if you have a history of:
- Bipolar disorder
- Mania or hypomania
- Psychosis
- Seizures
- Liver disease
- Significant heart conditions
- Bleeding disorders
- Pregnancy or breastfeeding
- Suicidal thoughts
- Previous severe medication reactions
Some antidepressants can interact with other medicines, supplements, alcohol, or substances.
Early worsening or suicidal thoughts
Some people may feel more anxious, agitated, restless, or emotionally unsettled when starting or changing antidepressants.
If you experience suicidal thoughts, feel unsafe, or notice severe agitation or unusual behaviour, seek urgent help.
In Australia:
- Emergency services: 000
- Lifeline: 13 11 14
- Suicide Call Back Service: 1300 659 467
- Beyond Blue: 1300 22 4636
Antidepressants and bipolar disorder
Antidepressants can sometimes worsen mood instability or trigger elevated mood in people with bipolar disorder.
Tell your psychiatrist if you have ever had periods of:
- Unusually elevated or irritable mood
- Reduced need for sleep
- Increased energy
- Racing thoughts
- Risk-taking
- Increased spending
- Increased confidence or grandiosity
- Talking more than usual
- Feeling unusually productive or invincible
Stopping antidepressants
Do not stop antidepressants suddenly unless advised by a clinician or in an emergency.
Stopping suddenly can cause withdrawal or discontinuation symptoms, such as:
- Dizziness
- Flu-like symptoms
- Irritability
- Sleep disturbance
- Anxiety
- Electric shock sensations
- Nausea
- Headache
- Mood changes
Your psychiatrist or GP can help you reduce medication gradually if needed.
Medication and therapy
Medication is one treatment option. Many people benefit from combining medication with:
- Psychological therapy
- Sleep support
- Exercise
- Routine changes
- Stress management
- Social support
- Addressing alcohol or substance use
- Treating underlying medical contributors
Follow-up
Follow-up appointments are important to review:
- Symptom changes
- Side effects
- Dose
- Safety
- Sleep
- Functioning
- Ongoing treatment goals
Important note
This information is general and may not apply to your situation. Your psychiatrist will provide personalised advice based on your symptoms, history, risks, preferences, and goals.