Adverse Effects Common to Most Antidepressants
In general, the different classes of antidepressants vary significantly in their side-effect profiles, which are discussed in each section of the antidepressant. However. every antidepressant has some properties common to the entire group. All antidepressants have the potential to induce a manic episode or to provoke rapid cycling between manic and depressed states. Patients with historie of bipolar disorder are most at risk for developing this effect, but it can occur even in patients with no previous history of mania or hypomania.
Almost all antidepressants have the potential to cause a discontinuation syndrome if they are stopped abruptly. This syndrome is thought not to be caused by classic dependence on the medication, but rather by the abrupt change in monoamine neurotransmission as the medicatioc plasma levels fall. The symptoms of the discontinuation syndrome tend to be similar to the symptoms of beginning an antidepressant and include dizziness, gastrointestinal upset, and jitteriness. Antidepressants with short half-lives (e.g., venlafaxine) seem to be more likely to cause a discontinuation syndrome than those with long half-lives (e.g., fluoxetine Because of this possible adverse effect, it is prudent to taper most antidepressants gradually.
There have been case reports of the syndrome of inappropriate antidiuretic-hormone release (SIADH) and consequent hyponatremia with many antidepressants. The mechanism of this effect is not known. Although antidepressant-induced SIADH is relatively rare, risk factors seem to be the advanced age of the patient and the use of serotoner antidepressants.
What are the Most Common Side Effects?
The most common side effects of the antidepressants are low blood pressure, feeling light-headed, trouble sleeping, sleepiness, dry mouth, weight gain and reduced tolerance for alcohol.
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