Whether or not someone has side effects, which side effects they have, and how frequent they are will depend on the drug and on the dose used. And everyone reacts slightly differently to drugs as well. The risk of side effects increases if other medication is also being taken. One of the drugs may make the side effects of the other worse. These kinds of drug interactions are common in older people and people with chronic illnesses who are taking several different kinds of medication.
Mindfulness-based therapy, self-practiced mindfulness, and meditation can reduce symptoms of depression and be effective coping tools. By living in the moment and getting in touch with your external surroundings, you can temporarily detach from the internal strife of your depression. You can also do this as part of yoga, another technique therapists frequently recommend.
Once diagnosed, a person with depression can be treated a number of ways. The most common treatments are medication and psychotherapy. Many studies show that cognitive behavioral psychotherapy is highly effective, alone or in combination with drug therapy. Psychotherapy addresses the thinking patterns that precipitate depression, and studies show that it prevents recurrence. Drug therapy is often helpful in relieving symptoms, such as severe anxiety, so that people can engage in meaningful psychotherapy.
Thyroid disease and disorder symptoms and signs depend on the type of the thyroid problem. Examples include heat or cold intolerance, sweating, weight loss or gain, palpitations, fatigue, dry skin, constipation, brittle hair, joint aches and pains, heart palpitations, edema, feeling bloated, puffiness in the face, reduced menstrual flow, changes in the frequency of bowel movements and habits, high cholesterol, hoarseness, brittle hair, difficulty swallowing, shortness of breath, a visible lump or swelling in the neck, tremors, memory problems, depression, nervousness, agitation, irritability, or poor concentration.
Explore options if it doesn't work well. If you have bothersome side effects or no significant improvement in your symptoms after four weeks, talk to your doctor about changing the dose, trying a different antidepressant (switching), or adding a second antidepressant or another medication (augmentation). A medication combination may work better for you than a single antidepressant.
Maybe. Some medicines, such as some types of antidepressants, may make it more difficult for you to get pregnant, but more research is needed.15 Talk to your doctor about other treatments for depression that don’t involve medicine if you are trying to get pregnant. For example, a type of talk therapy called cognitive behavioral therapy (CBT) helps women with depression.16 This type of therapy has little to no risk for women trying to get pregnant. During CBT, you work with a mental health professional to explore why you are depressed and train yourself to replace negative thoughts with positive ones. Certain mental health care professionals specialize in depression related to infertility.
Light therapy—This treatment has been proven effective for people with seasonal affective disorder. It involves sitting near a special kind of light for about half an hour a day. Light therapy should not be done without first consulting your doctor because there are side effects to this treatment. It is being researched for use in other kinds of depression as well.
Antianxiety drugs such as diazepam (Valium), alprazolam (Xanax), and lorazepam (Ativan) are not antidepressants, but doctors occasionally prescribe these alone or with antidepressants for a brief period of anxiety. However, patients should not take these alone for depressive disorder. Due to their addiction potential, patients should phase out the antianxiety drugs as soon as the antidepressant and antianxiety effects of the antidepressant medications begin to work, which is usually in four to six weeks.
Some people find that herbal remedies, such as St. John’s Wort, help with their depression symptoms. Remember that even herbal remedies can have side effects and may interfere with other medications. Dosages can also vary depending on the brand you use. Talk about the risks and benefits of herbal or other alternative treatments with your health care provider and make sure they know all the different treatments you’re trying.
Develop good habits. Take your depression medicine at the same time every day. It's easier to remember if you do it along with another activity such as eating breakfast or getting into bed. Get a weekly pillbox, which will make it easy to see if you've missed a dose. Since people sometimes forget a dose now and then, make sure you know what to do if that happens.
Depressive disorders are mood disorders that have been with mankind since the beginning of recorded history. In the Bible, King David, as well as Job, suffered from this affliction. Hippocrates referred to depression as melancholia, which literally means black bile. Black bile, along with blood, phlegm, and yellow bile were the four humors (fluids) that described the basic medical physiology theory of that time. Literature and the arts have portrayed depression, also referred to as clinical depression, for hundreds of years, but what do we mean today when we refer to a depressive disorder? In the 19th century, people thought of depression as an inherited weakness of temperament. In the first half of the 20th century, Freud linked the development of depression to guilt and conflict. John Cheever, the author and a modern sufferer of depressive disorder, wrote of conflict and experiences with his parents as influencing his becoming clinically depressed.
Many migraine patients suffer from symptoms of depression and anxiety. Migraine patients are between two to five times more likely to have these symptoms than patients without migraine. About 25% of patients with migraine have depression, and about 50% have anxiety. Some patients have symptoms of these disorders after living with migraine for years. Others develop them before migraine. At this time, scientists don’t know the exact answer why all are so common. One of the brain chemicals involved in all these conditions is called serotonin. Hormone changes in women can also trigger both conditions.
Fluvoxamine enhances serotonin activity due to selective reuptake inhibition at the neuronal membrane. It does not significantly bind to alpha-adrenergic, histamine, or cholinergic receptors and thus has fewer side effects than tricyclic antidepressants. Fluvoxamine is a strong inhibitor of cytochrome P-450. Although fluvoxamine is FDA approved only for obsessive-compulsive disorder, it is commonly prescribed for other psychiatric disorders, including social anxiety disorder, posttraumatic stress disorder, pain disorder, and major depression.
People should try to avoid mixing medications of any kind (prescribed, over the counter, or borrowed) without consulting their doctor. Patients should inform their dentist or any other medical specialist who prescribes a drug that he or she is taking antidepressants. Some medications that are harmless when taken alone can cause severe and dangerous side effects when taken with other medications. This may also be the case for individuals taking supplements or herbal remedies. Some addictive substances, like alcohol (including wine, beer, and liquor), tranquilizers, narcotics or marijuana, reduce the effectiveness of antidepressants and can cause mental health and/or physical symptoms. Patients should avoid these. These and other drugs can be dangerous when the person's body is either intoxicated with or withdrawing from their effects due to increasing the risk of seizure or heart problems in combination with antidepressants medications.
The US Food and Drug Administration issued a safety information update in December 2011 concluding that it is unclear whether the use of SSRIs during pregnancy causes persistent pulmonary hypertension in the newborn. The FDA currently recommends that health care professionals and patients weigh the small potential risk of persistent pulmonary hypertension against the substantial risks of untreated depression during pregnancy. 
Bennabi D, Yrondi A, Charpeaud T, Genty JB, Destouches S, et al. Clinical guidelines for the management of depression with specific comorbid psychiatric conditions French recommendations from experts (the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental). BMC Psychiatry. 2019 Jan 30. 19 (1):50. [Medline].
Selective serotonin reuptake inhibitors (SSRIs) were launched in the mid to late 1980s. This generation of antidepressants is now the most common class used for depression. Examples include citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil, Pexeva), fluoxetine (Prozac, Sarafem), and sertraline (Zoloft). Two medicines, classified as "serotonin modulators and stimulators" or SMS's (meaning they have some similar properties as SSRIs but also affect other brain receptors) are vilazodone (Viibryd) and vortioxetine (Trintellix) Side effects are generally mild, but can be bothersome in some people. They include nausea, stomach upset, sexual problems, fatigue, dizziness, insomnia, weight change, and headaches.
For patients who are unable to switch from an older SSRI to either a newer SSRI or to another class of antidepressants either because of lack of tolerance or lack of therapeutic response, the doctor may consider adding another medication to the SSRI. For example, some doctors have reported success by adding bupropion to SSRIs to improve sexual function.
Monoamine oxidase inhibitors (MAOIs) block the activity of monoamine oxidase, an enzyme that breaks down norepinephrine, serotonin, and dopamine in the brain and other parts of the body. MAOIs have many drug and food interactions and cause significant side effects in comparison to the new antidepressants. As such, MAOIs have been replaced by newer antidepressants that are safer and cause fewer side effects.
You may have heard about an herbal medicine called St. John's wort. Although it is a top-selling botanical product, the FDA has not approved its use as an over-the-counter or prescription medicine for depression, and there are serious concerns about its safety (it should never be combined with a prescription antidepressant) and effectiveness. Do not use St. John’s wort before talking to your health care provider. Other natural products sold as dietary supplements, including omega-3 fatty acids and S-adenosylmethionine (SAMe), remain under study but have not yet been proven safe and effective for routine use. For more information on herbal and other complementary approaches and current research, please visit the National Center for Complementary and Integrative Health website.