Depression Treatments and Medications

What are common side effects of depression medications?

As with all medications, antidepressants may cause undesired responses to the medication. While these side effects often diminish within a few weeks of use, some may persist for longer.

Consult your doctor about the risks and benefits of a particular medication. Many people find the benefits outweigh the risks; however, some people find it challenging to tolerate some side effects. You should always seek medical advice before stopping a medication.

Common side effects of selective serotonin reuptake inhibitors (SSRIs) may include:

• Sexual dysfunction

• Drowsiness

• Weight gain

• Insomnia

• Anxiety

• Dizziness

• Headache

• Dry mouth

• Blurred vision

• Nausea

• Rash or itching

• Tremor

• Constipation

• Stomach upset

Common side effects of serotonin and norepinephrine reuptake inhibitors (SNRIs) may include:

• Nausea

• Dry mouth

• Headache

• Dizziness

• Sweating

• Insomnia

• Constipation or diarrhea

• Fatigue

• Increased heart rate

• Erectile dysfunction

• Decreased appetite

Common side effects of atypical antidepressants may include:

• Dry mouth

• Drowsiness

• Sedation

• Nausea

• Insomnia

• Appetite increased

• Weight increased

• Dizziness

• Anxiety

• Dyspepsia

• Sinusitis

• Tremor

Tetracyclic and tricyclic antidepressant side effects may include:

• Dry mouth

• Constipation

• Headache

• Feeling nervous

• Mouth sores

• Changes in taste

• Weight gain or loss

• Excessive sweating

• Heart palpitations

Monoamine oxidase inhibitors (MAOIs) side effects may include:

• Sleepiness during the daytime

• Dizziness

• Low blood pressure

• Dry mouth

• Headache

• Upset stomach

• Back pain

• Constipation or diarrhea

• Difficulty urinating

Esketamine side effects may include:

• Feeling disconnected from one's body and thoughts

• Altered perception of reality

• Decreased awareness of surroundings

• Sedation

• Nausea

• Dizziness

• Headache

• Distorted taste

• Diminished sense of touch

• Anxiety

• Fatigue

• Increased blood pressure

• Vomiting

Serotonin syndrome

In addition to these side effects, many antidepressants may carry a risk of serotonin syndrome, which occurs when the level of serotonin rises to a dangerous level. It is rare and typically happens when combining antidepressants or medications that increase serotonin levels. For example, taking the herbal supplement St. John’s Wort may increase the risk of serotonin syndrome when taking it with another antidepressant. Symptoms of serotonin syndrome may include:

• Anxiety

• Confusion

• Agitation

• Sweating

• Muscle twitching or spasm

• Shivering, shaking, or trembling

• Diarrhea

• Fever

• Increased heart rate

• Rapid eye movements

• Vomiting

If you experience these symptoms while taking an antidepressant, you may need to seek immediate medical attention.

Depression treatment without medication

Exercise

Besides the physical benefits, such as protecting against heart disease or diabetes, improving sleep, and lowering blood pressure, exercise may also help improve emotional and mental health. High-intensity exercise can cause the brain to release endorphins, which are considered the feel-good chemicals, according to Harvard Health. Low-intensity activity sustained over time may also offer benefits. When you exercise, your body releases neurotrophic or growth factor proteins, which may lead to new connections between nerve cells and improved brain function.

Meditation

Meditation may help decrease depressive symptoms, according to John Hopkins Medicine. Madhav Goyal, M.D., reviewed 47 studies on meditation and found that it “appeared to provide as much relief from some depression symptoms as other studies have found with antidepressants.” Mindfulness meditation, which involves focusing on the present moment, was found to be most effective. Goyal believes that regular meditation can help reduce the worries and fears that accompany depression.

Diet

What you eat may also affect symptoms of depression. A study published in 2017 found that eating a modified Mediterranean diet, which is high in vegetables, fruits, whole grains, fish, legumes, nuts, and extra virgin olive oil, improved mental health. The results found that around 30% of those who ate a healthy diet achieved remission from major depression. Only 8% of those in the control group experienced an improvement in depression symptoms.

Sleep Hygiene

Getting adequate sleep may be helpful in managing episodes of depression. Studies have shown that individuals who improved their sleep quality experienced a significant reduction in depression symptoms, positively affecting their daily life. Healthy sleep hygiene habits may include keeping a consistent sleep schedule, avoiding electronic devices before bed, and creating a comfortable resting environment.

Social support

Social support in the form of assistance and emotional or physical comfort from friends and family may also have a positive impact on symptoms of depression. One study found that individuals with depression who received strong social support, such as from family members, were more likely to see improvements in their condition. Therefore, being able to depend on a strong network for support from others may be beneficial for mental well-being.

Natural treatments – herbs and supplements

St. John’s Wort – A review of studies, which looked at 35 studies with 6,993 participants, found that St. John’s Wort is more effective than a placebo and may be similarly effective to antidepressant medication for people with mild to moderate depression. However, St. John’s Wort may cause adverse effects and be linked to drug interactions that may increase the risk of serotonin syndrome.

Chamomile – A small study in 2012 found that chamomile may provide more relief from depression than a placebo. However, this study was small, with only 57 participants. Further studies are needed before determining the benefits of this herbal supplement for treating depression.

Saffron – Saffron might be an effective way of managing symptoms of depression and anxiety, according to a review of studies published in 2018. The herb may have antidepressant effects with fewer side effects than conventional antidepressants. However, more research is needed to confirm its effects.

Omega-3 fatty acids – Omega-3 fatty acids, found in fatty fish, walnuts, and flaxseeds, have been linked to improvements in depression symptoms. Omega-3 fatty acid supplements may be a potential option for managing depression alongside other treatments. One analysis of 26 different studies found that omega-3 fatty acids may help improve depression symptoms.

Finding the right depression treatment

Finding the right treatment for depression starts with getting a proper diagnosis, which may include various medical tests done by your doctor or a mental health specialist. After a diagnosis, you may work closely with your healthcare provider, who will consider things like the type of depression you have, whether you have any other mental health issues, and the medical history of you and your family.

A healthcare provider will work with you to create an appropriate treatment plan. This plan might include different options, such as talk therapy, medication, and lifestyle changes. For example, cognitive therapy, dialectical behavior therapy, and interpersonal therapy are forms of talk therapy that may be useful in treating depression. In addition, you may be recommended medication, which can include different types of antidepressants.

In many cases, finding the right depression treatment can involve a process of trial and error. You might find that a particular treatment option is not working to relieve your symptoms after some time. However, various treatment options are available, and it’s normal to work with a healthcare provider in trying different options to find the one that works for you.

Frequently asked questions about depression

What are the different types of depression medications?

There are several types of antidepressants available. First-line treatments for depression include second-generation antidepressants, such as SSRIs, SNRIs, and atypical antidepressants. Older antidepressants, which tend to have more side effects or drug interactions, include tetracyclic antidepressants, tricyclic antidepressants, and MAOIs. Esketamine is a relatively new medication that was approved by the FDA in 2019 and is classified as an NMDA antagonist.

Are stimulants used to treat depression?

Stimulant medications, such as Ritalin or Adderall, are not considered a first-line treatment for depression. However, they may be prescribed off-label as an add-on treatment for people who have not had an adequate response to antidepressants alone. Stimulants might help with certain depressive symptoms, such as fatigue, loss of energy, and impaired concentration.

What is the most popular antidepressant? What are the common antidepressants?

SSRIs are the most commonly prescribed types of antidepressants. Some common SSRIs include Prozac (fluoxetine), Zoloft (sertraline), Celexa (citalopram), Paxil (paroxetine), and Lexapro (escitalopram).

What is the best depression medication without side effects?

All antidepressants have the potential to cause side effects. However, everyone reacts to medication differently, so what works for one person might not work for another. Not everyone may experience side effects, and those that do can experience them differently.

What is the best natural antidepressant?

While there are many natural remedies that people use to help manage depression symptoms, there is no single "best" natural antidepressant that works for everyone. Lifestyle changes, such as a healthy diet and regular exercise, may help naturally reduce symptoms of depression. In addition, some natural remedies that have been studied for their potential antidepressant effects include St. John's wort, omega-3 fatty acids, and saffron. It’s important to consult a healthcare provider before trying an herbal remedy for depression due to potential side effects and drug interactions.

What is the best method to treat depression?

The most appropriate method to treat depression will depend on different factors, such as the severity of symptoms, possible causes, risk factors, and the individual’s medical history. For example, certain treatments may be tailored to specific types of depression, such as seasonal affective disorder or premenstrual dysphoric disorder. In general, a combination of talk therapy and medication has been shown to be effective in treating major depression. For those with mild depression or specific situations, such as pregnant women or older adults, lifestyle changes and specific adjustments in treatment may be recommended.

How do antidepressants work?

Antidepressants are believed to work by balancing certain chemicals or neurotransmitters in the brain. For example, people with depression might have low serotonin, norepinephrine, or dopamine levels. Antidepressants may work in different ways to increase the levels of these neurotransmitters and improve symptoms.

Which type of therapy is often used to treat depression?

Cognitive-behavioral therapy (CBT) is a common psychotherapy used to treat depression. This therapy focuses on identifying negative thought patterns and replacing them with healthy, balanced thought patterns. CBT also provides practical solutions for problem-solving and creating steps to take after noticing early signs of a depressive episode.

Do I need a psychiatrist or psychologist?

Some people may be treated for depression by their primary physician. However, you may be referred to a psychologist or psychiatrist for further evaluation and treatment, depending on the severity of your symptoms. Psychiatrists are medical doctors who primarily treat mental health disorders with medication, while psychologists focus on psychotherapy and other techniques for treating mental illness.

What do doctors do for anxiety?

The treatment used for anxiety disorders may be similar to that used for depression. A healthcare provider may recommend psychotherapy, medication, or both for anxiety. Antidepressants, like SSRIs and SNRIs, may help treat anxiety and depression. Lifestyle changes and mindfulness practices may also be recommended to help improve anxiety symptoms.