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January 10, 2023

Finding the Right Antidepressant for You

Antidepressants are prescription medications that are often used to treat and reduce the symptoms of depression. They may also be used to help treat anxiety, chronic pain, insomnia, or other health conditions. According to a September 2020 data brief published by the Centers for Disease Control and Prevention (CDC), between 2015 and 2018 more than 13% of adults ages 18 and older had taken an antidepressant within 30 days of being asked about antidepressant use. Women were more likely to take antidepressants than men (17.7% versus 8.4%), and usage increased with age in both men and women.

Types of Antidepressants

Every person responds to antidepressants differently. That’s why there are many types of antidepressants, all of which work in different ways. All antidepressants can cause side effects, though many may be temporary. Types of antidepressants include:

  • Selective serotonin reuptake inhibitors (SSRIs), are typically prescribed first by a provider because they tend to have fewer side effects. These antidepressants affect a chemical called serotonin in the brain and include the medications citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline.
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs) affect both serotonin and norepinephrine chemicals. Duloxetine, venlafaxine, and desvenlafaxine are examples of SNRIs.
  • Atypical antidepressants include bupropion, trazodone, and mirtazapine. These are newer antidepressants that don’t easily fit into other groups, which is why they are called “atypical.”
  • Tricyclic antidepressants are one of the oldest types of antidepressants and affect serotonin, norepinephrine, and dopamine. They are less frequently prescribed due to increased side effects and can take longer to work compared to SSRIs and SNRIs. Tricyclic antidepressants include amitriptyline, clomipramine, desipramine, doxepin, imipramine, nortriptyline, protriptyline, and trimipramine.
  • Monoamine oxidase inhibitors (MAOIs) affect monoamine, an enzyme that is found in the brain and can have severe side effects and interactions with other medications. They are typically prescribed as a last option and include isocarboxazid, phenelzine, selegiline, and tranylcypromine.

How Long Does It Take for Antidepressants to Work?

When you feel depressed, it’s understandable to want immediate relief. However, it can take several weeks for an antidepressant to work, depending on the type. Some symptoms of your depression (like sleeping or eating problems) may improve before you notice a change in your mood. Your health care provider will help you determine the duration for which you should take the medication. Many treatment plans begin with a 6-12 month period, although many people may benefit from taking antidepressants longer than that. Many people who take antidepressants find that they are better able to engage with activities and people that are important to them in life.

Be patient. You may need to try different types and doses before finding an antidepressant that works for you. Your health care provider is there to help you with a treatment plan to meet your needs.

Considerations and Precautions for Antidepressants

Be open and honest with your health care provider when discussing antidepressant medication so he or she can identify any precautions you should take. Talk with your doctor about:

  • Any history of depression, including relatives who have been treated, and what medications were used
  • Additional health issues or medications you’re taking
  • If you are pregnant or plan to become pregnant
  • Alcohol or drug use and possible effects
  • Budget concerns you may have

Be sure to take your medication consistently and according to the directions. Never stop taking your antidepressant without first speaking to your doctor. This may cause antidepressant discontinuation syndrome, a temporary condition that may cause anxiety, feelings of sadness, irritability, nausea, fatigue, and dizziness. Tell your doctor why you wish to stop taking your medication. Remember, your provider is there to offer alternatives so you can find the antidepressant that’s right for you and start living a happier, healthier life.

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