A significant number of people who are prescribed these drugs stop taking them because of unpleasant and worrying side effects. If you are already depressed, struggling with some of the drugs’ adverse effects can make you feel even more distressed, especially as the worst of these effects tends to occur at the beginning of treatment, before the drugs have started to lift the depression.
You may not experience any of the adverse effects listed in this lesson, or the ones that affect you may be no more than a minor inconvenience, which you consider an acceptable price to pay for the benefits the drugs give you. However, if they do cause troublesome or unpleasant side effects, don’t hesitate to tell your doctor, if necessary by letter. You are the best judge as to whether or not the drugs are working for you.
Many antidepressants are very dangerous if more than the prescribed dose is taken. They should be prescribed in small amounts only, taken with great care and stored out of reach of children. It’s very important not to increase the dose above that prescribed by your doctor. Doctors should keep in close contact with you, especially at the beginning of your treatment. You should be able to visit your doctor to discuss any adverse effects you experience.
There is a warning from the Committee on Safety of Medicines about low blood sodium levels (hyponatraemia) associated with all antidepressants. This mainly affects elderly people. Signs of this are drowsiness, confusion or convulsions.
Antidepressants may affect driving and other skilled tasks.
Drugs that cause a dry mouth may cause tooth decay as a secondary effect. Saliva is important in protecting against tooth decay, and there have been several reports of people developing dental problems, especially after long-term use of tricyclic and related antidepressants.
There is a possibility that taking antidepressants may make people feel suicidal when they had not felt this way before they started the medication. Suicidal feelings have mainly been associated with SSRI antidepressants, with many published anecdotes, but there is a suggestion that the same thing may occur with other types of antidepressants too. It is possible that when someone is very depressed they cannot summon up the motivation or energy for suicide, and in the early stages of treatment this changes so that they then do have the energy to act before the depression has really started to lift. This has usually been the explanation for suicide in the early stages of treatment. However, the suggestion that the drugs themselves cause suicidal thoughts and urges is increasingly being taken seriously, and this issue is discussed below in relation to SSRI antidepressants in particular.
If someone is so depressed that they sometimes feel suicidal, it might be advisable for a relative or close friend to help them to look after their tablets so the right dose is taken at the right time.