Antidepressants

Expert reviewer: Dr Sammad Hashmi, Consultant Psychiatrist
Content editor review by Lucy Kapoutsos, Health Content Editor, March 2023
Next review due April 2026

Antidepressants are a type of medicine used to mainly treat depression. There are different types of antidepressant medicine – your doctor will recommend the one that’s best for you and your circumstances.

It can take a few weeks to notice any change in your symptoms after starting an antidepressant. All antidepressants can have side-effects, but for many people these are mild and get better over time.

When are antidepressants used?

Antidepressants are mainly used to treat depression , often alongside talking therapies , like counselling or cognitive behavioural therapy (CBT). Your doctor may prescribe antidepressants if you have moderate or severe depression and your symptoms make daily life difficult.

If your depression is mild, antidepressants may not be the best treatment. But if you’ve had depression before, or you’ve previously had more severe depression, antidepressants may be an option.

If you’ve had depression which has come back in the past, your doctor may suggest you take antidepressants to help prevent it from coming back again. But, this depends on what types of treatment worked best for you previously.

Antidepressants may be used as a treatment for other mental health conditions. These include:

anxiety, including long-term anxiety and generalised anxiety disorder
panic disorder
phobias, such as agoraphobia and social phobia
obsessive compulsive disorder
post-traumatic stress disorder
bulimia, an eating disorder

Sometimes, antidepressants are used for other reasons including:

long-term pain
symptoms of the menopause, such as hot flushes
bedwetting in children
urinary stress incontinence
to help you stop smoking

There are several different antidepressants. They usually take some time to work and need to be taken regularly to see if they’ll work for you. If you get worrying side-effects or the medicine doesn’t work, your doctor may offer you a different one. There are many options, so don’t lose hope.

If you need help now

This page is designed to provide general health information. If you need help now, please use the following services.

Samaritans. 116 123 (UK and ROI) - This helpline is free for you to call and talk to someone.
NHS Services has a list of where to get urgent help for mental health.
Mind website. Click the ‘Get help now’ button on the page. This is a tool that is designed to help you understand what’s happening to you and how you can help yourself.

If you think you might harm yourself or are worried someone else might come to immediate harm, call the emergency services on 999 or go to your local accident and emergency department.

How do antidepressants work to treat depression?

Most antidepressants increase the amount of chemicals (called neurotransmitters) in your brain. Neurotransmitters transmit messages between the cells in your brain and are thought to help regulate your mood. It may take up to four weeks for antidepressants to start fully working and reduce symptoms of depression.

What are the different types of antidepressant?

There are different types of antidepressant, which include:

selective serotonin reuptake inhibitors (SSRIs), such as citalopram, fluoxetine and sertraline
serotonin–noradrenaline reuptake inhibitors (SNRIs), such as duloxetine and venlafaxine
tricyclic antidepressants (TCAs), such as lofepramine and imipramine
monoamine oxidase inhibitors (MAOIs), such as tranylcypromine and phenelzine

There are other types of antidepressant that fall outside of these categories. These include mirtazapine and vortioxetine.

The different types of antidepressant all work equally well for treating depression. If your doctor recommends you take an antidepressant, they’ll probably prescribe an SSRI first. This is because SSRIs are generally safer and their side-effects are tolerated better. For more information on this, see our section on Side-effects below.

Your doctor will talk you through which medicine is the best option for you. This may depend on your symptoms, what worked before, other medicines you take, other medical conditions you have, and your own preferences.

Ask your doctor to explain the risks and benefits of any medicines they recommend, so that you feel fully informed when starting your treatment. You may need to try different medicines before you find one that works for you.

Taking antidepressants

If your doctor prescribes you an antidepressant, they’ll want to see you again within a couple of weeks to see if it’s working for you. After that, you’ll probably need to go back each month for three months.

Some people find that their symptoms start to improve a few days after starting antidepressants. But it often takes two to four weeks. That’s why it’s important to keep taking your medicine, even if you don’t feel better straightaway.

Once you’ve found an antidepressant that works for you, you’ll probably need to keep taking it for at least six months after your symptoms have gone away. This will help prevent your depression from coming back. Your symptoms might come back when you stop taking your medication, so always follow your doctor’s advice. If you’ve had depression that has come back in the past, you may need to continue taking your antidepressants for longer – for at least two years.

You do not become addicted to antidepressants. Unlike addictive drugs, you won’t need increasing amounts to get the same effect, and you won’t crave them. But you can get some unpleasant symptoms if you stop taking them too quickly. For more information about stopping antidepressants, see our section on Side-effects below.

Always read the patient information that comes with your medicine. And if you have any questions about taking your medicine, ask your pharmacist.

Driving and antidepressants

Some antidepressants can make you sleepy and affect your ability to drive safely. This is most likely to be a problem in the first month after starting your treatment or if your dose is increased. The Driver and Vehicle Licensing Agency (DVLA) states that you should not drive if your medication affects your level of alertness or your ability to concentrate. Talk to your doctor about whether your medicine could affect your driving. Remember that it is always your responsibility to ensure that you’re safe to drive if you get behind the wheel.

Do antidepressants interact with other medicines?

Antidepressants can interact with other medicines, so tell your doctor about any other medicines that you’re taking. You might find it helpful to take a list of what you’re currently taking with you to your appointment. This includes any over-the-counter or complementary medicines. The patient information leaflet that comes with your medicine will give you details of any important interactions. Read this leaflet carefully as soon as you get your medicine and if you have any questions or concerns, you can ask your pharmacist for advice.

Can I drink alcohol while taking antidepressants

It’s best to avoid alcohol while you’re taking antidepressants. This is because:

alcohol is a depressant, and can lower your mood
alcohol and antidepressants together can make you very sleepy
some antidepressants can increase the effects of drinking alcohol

If you’re taking a monoamine oxidase inhibitor (MAOI) antidepressant, you shouldn’t drink alcohol at all. There are also some other restrictions on your diet with MAOIs – you can get more information from the patient leaflet that comes with your medicine, or ask your pharmacist.

What are the side-effects of antidepressants?

Like all medicines, antidepressants can cause side-effects. These are unwanted effects you may get after taking your medicine. Side-effects are most likely to happen when you first start treatment with an antidepressant. For most people, the side-effects are mild and improve after a few weeks. It’s important to keep taking your medicine if you can.

Some antidepressants have fewer side-effects than others. For example, selective serotonin reuptake inhibitors (SSRIs) and serotonin–noradrenaline reuptake inhibitors (SNRIs) have fewer side-effects than tricyclic antidepressants (TCAs) and monoamine oxidise inhibitors (MAOIs).

The most commonly prescribed type of antidepressant is an SSRI. This is because the side-effects of SSRIs are more tolerable than those of other types of antidepressant.

The side-effects of SSRIs may include:

feeling sick or being sick (vomiting)
tummy pain
diarrhoea
constipation
feeling dizzy
feeling anxious
feeling agitated
having trouble sleeping
a low sex drive

An uncommon serious side-effect that can happen after taking SSRI antidepressants is known as serotonin syndrome. This happens when your body gets too much of a chemical called serotonin. Symptoms can include:

confusion
shivering
sweating
having twitching muscles

If you’re experiencing any of these symptoms, seek medical help immediately.

It’s thought that young people may be slightly more likely to have suicidal thoughts when taking SSRI antidepressants. If you think you might harm yourself or are worried someone else might come to immediate harm, call the emergency services on 999. Or, see the section on 'if you need help now’ for further details of organisations that can help.

Children and young people will only be offered these medicines after careful assessment by a psychiatrist, and will be monitored closely.

You can ask your doctor about the side-effects of other types of antidepressant. There will also be details of possible side-effects in the patient information leaflet that comes with your medicine.

It’s normal to experience some side-effects from taking antidepressants. But if you’re concerned about any side-effects you may be having, talk to your doctor. They may be able to prescribe another type of antidepressant to see if it suits you better.

Side-effects when stopping antidepressants

If you take antidepressants for more than six to eight weeks and then stop, you may get what are called ‘discontinuation symptoms’. These include:

feeling sick (nausea)
problems sleeping, including vivid dreams and insomnia
restlessness
altered sensations, such as ‘electric shock’ sensations in your head
anxiety, irritability and confusion

Not everyone gets these, but they’re more likely to happen if you stop taking your medicines suddenly or miss doses. So, if you’d like to stop taking your antidepressants, talk to your doctor first. They may help you reduce your dose slowly, over a period of weeks, to prevent these side-effects.

Medicines checklist

Our handy medicines checklist helps you see what to check for before taking a medicine.

Bupa's medicines checklist PDF opens in a new window (0.8MB)

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Antidepressants can cause side-effects. They’re most likely to happen when you first start treatment. They’re usually mild and improve after a few weeks.

Common side-effects include:

feeling sick or being sick
tummy pain
diarrhoea
constipation
dizziness
feeling anxious
difficulty sleeping
a low sex drive

For more information, see the section ‘Side-effects’.

If your doctor recommends taking an antidepressant, they’ll probably prescribe a selective serotonin reuptake inhibitor (SSRI) first. SSRIs are generally safer and their side-effects are tolerated better.

Your doctor will talk you through which medicine is the best option. This may depend on your symptoms, what worked best for you before, other medicines you take, other medical conditions you have, and your own preferences. For more information, see the section ‘types of antidepressant’.

Antidepressants are mainly used to treat depression. If you think you might have depression, your doctor will be able to advise whether antidepressants are a suitable treatment option based on your individual circumstances.

Antidepressants are also used to treat other conditions, such as anxiety, long-term pain and urinary stress incontinence. If you have any of these conditions, your doctor can advise whether antidepressants might be able to help.

It may take around four weeks for antidepressants to start working and reduce the symptoms of depression. After this, if you feel the antidepressant you’re taking isn’t working, contact your doctor. They may offer you another antidepressant.

Don’t stop taking antidepressants suddenly without speaking to your doctor, as this can cause unpleasant side-effects.

If you’re taking antidepressants for another condition, your doctor can advise when you might see your symptoms improve. For more information, see the sections on ‘Side-effects’ and ‘how they work’.

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