The leading cause of disability in the United States is major depressive disorder according to the National Institute of Mental Health. Major depressive disorder affects more women than men and 14.8 million people in the United States have a major depressive disorder. Treatment with antidepressants is common but these medications can have significant side effects.
Suicide
In response to continued reports regarding the link between suicide and taking antidepressants, both serotonin reuptake inhibitors--SSRIs--and tricyclic antidepressants, the Food and Drug Administration has issued a black box warning for antidepressants particularly in patients who are younger than 24 years old. A black box warning is the highest level of alert for a medication from the FDA. This warning states that patients who are taking antidepressants, particularly in the first couple of months, should be monitored closely by a health care provider and family. Warning signs are rapidly deteriorating symptoms such as hostility, anxiety, agitation or an increase in the severity of depression. These symptoms should be reported immediately to a health care provider.
Sexual Side Effects
Most antidepressants cause some sexual side effects, including lack of libido or desire and erectile dysfunction. These effects may lessen over time. The SSRIs all affect sexual function according to MayoClinic.com. Medications in this class of drugs include citalopram, brand name Celexa; escitalopram, Lexapro; fluoxetine, Prozac and Prozac Weekly; fluvoxamine, Luvox; paroxetine, Paxil and Paxil CR; and sertraline, Zoloft. Serotonin-norepinephrine reuptake inhibitors--SNRIs--may have fewer sexual side effects, but more research is needed to confirm this. This class includes includes venlafaxine, brand name Effexor; and duloxetine, Cymbalta. Bupropion, brand name Wellbutrin, seems to have the least sexual side effects.
Weight Gain
Weight gain can be significant when using antidepressants. While on antidepressants a weight gain of 5 to 10 pounds or more can occur. According to MayoClinic, weight gain is associated with most antidepressants, and people who gain weight within the first week of use are more likely to have a problem with significant weight gain with long-term use. The tricyclics and monoamine oxidase inhibitors--MAOIs-- are more likely to cause weight gain than the SSRIs, with the exception of Paxil. Depressed patients on antidepressants may gain weight as their mood improves and they regain their appetite. A depressed mood can lead to overeating and cause weight gain. Weight gain while on antidepressants should be discussed with a health care provider.
References
- National Institute of Mental Health: The Numbers Count
- HelpGuide.org: Antidepressants
- MayoClinic.com: Antidepressants-Which Cause the Fewest Sexual Side Effects?
- Agency for Healthcare Research and Quality: Antidepressant Medications, A Guide for Adults with Depression
- MayoClinic.com: Antidepressants and Weight Gain: What Causes It?
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