Medicines for Depression
Antidepressant medicines may improve or completely relieve the symptoms of depression. If you are mildly depressed, you may not have to take them. But many people with moderate depression and most people with severe depression need medicine.
Antidepressant medicines work in different ways. No single first-line antidepressant works better than another, but different ones work better or worse for different people. The side effects of antidepressant medicines are different and may lead you to choose one instead of another.
You may have to try different medicines or take more than one to help your symptoms. Most people find a medicine that works within a few tries. Other people take longer to find the right one and may need to take the antidepressant and another type of medicine, such as an antiseizure, mood stabilizer, antipsychotic, or antianxiety medicine.
Together you and your healthcare provider will decide if you need medicine. You will also decide what things you'll need to think about if you need medicine and which medicine is right for you.
Antidepressant medicines include:
Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), paroxetine (Paxil), citalopram (Celexa), escitalopram (Lexapro), and sertraline (Zoloft)
Serotonin/norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor, Effexor XR) and duloxetine (Cymbalta)
Tricyclic and tetracyclic antidepressants, such as doxepin (Sinequan) and nortriptyline (Aventyl, Pamelor)
Other antidepressants, such as bupropion (Wellbutrin, Wellbutrin SR), mirtazapine (Remeron), and trazodone
Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan), phenelzine (Nardil), and selegiline (Emsam)
How long will you need to take medicine?
If you take antidepressants, you should take them for at least 6 months after you begin to feel better. This can help prevent you from feeling depressed again (relapse). If this is not the first time you have been depressed, your healthcare provider may want you to take these medicines even longer.
You may start to feel better within 1 to 3 weeks after starting your antidepressant medicine. But it can take as many as 6 to 8 weeks to see a great deal of improvement. If you have questions or concerns about your medicines, or if you do not notice that you feel better by 3 weeks, talk with your healthcare provider.
Some people need to stay on medicine for several months to years. Others will need medicine long-term. This is more likely if you have had:
Several bouts of depression
Bouts of depression that you had to treat in the hospital
Bouts of depression that led you to attempt suicide
Don't quit taking your medicines without first talking with your healthcare provider. If you quit suddenly, it can cause dizziness, anxiety, fatigue, and headache. If you and your healthcare provider decide you can quit using medicine, gradually reduce the dose over several weeks with their help.
Side effects and safety
Antidepressant medicines have side effects. You may notice the side effects before you notice that the medicine is helping you. Side effects vary depending on the medicine you take.
Common side effects include diarrhea, headaches, loss of sexual desire, not feeling like eating, having an upset stomach, and feeling on edge.
Most side effects are mild and will go away after you take the medicine for a few weeks.
Call your healthcare provider right away and stop taking the medicine if you have serious side effects, such as chest pain, hives, shortness of breath, trouble swallowing, swelling of your lips, or increased suicidal thinking.
If your side effects are less serious but bother you, talk with your healthcare provider about how to deal with the side effects or to see whether you should try another antidepressant medicine.
Antidepressant medicines have helped many people and are considered safe. But like all medicines, they may cause problems in certain people.
People who are taking medicines for other health problems need to know about medicine interactions. Talk with your healthcare provider about the best way to track whether a combination of medicines is harming you. People who are taking a lot of medicines also are more likely to have harmful side effects.
Do You Have Thoughts About Suicide?
If you or a loved one has thoughts about death or suicide, call 911 or the Veterans Crisis Line at 800-273-TALK (800-273-8255) and press 1, or use other emergency services. Or you can chat with a trained counselor online at www.VeteransCrisisLine.net.