There are several important things to consider when taking antidepressants. You should discuss these with your GP or mental health professional.
Antidepressants can react unpredictably with other medications, including over-the-counter medications like ibuprofen. Always read the patient information leaflet that comes with your medication. This will let you know if there are any medications you should avoid.
If in doubt, your pharmacist or GP should be able to advise you.
As a precaution, antidepressants aren't usually recommended for pregnant women, especially during the early stages of a pregnancy. However, exceptions can be made if the risks posed by depression (or other mental health conditions) outweigh any potential risks of treatment.
Potential complications that have been linked to using antidepressants during pregnancy include:
- loss of the pregnancy
- birth defects affecting the baby’s heart (congenital heart disease)
- pulmonary hypertension, a rare condition in newborns where the blood pressure inside the lungs is abnormally high, causing breathing difficulties
If you're pregnant and depressed, you should discuss the pros and cons of antidepressants with the doctor in charge of your care.
As a precaution, using antidepressants while breastfeeding isn't usually recommended.
However, there are circumstances when both the benefits of treatment for depression (or other mental health conditions) and the benefits of breastfeeding your baby outweigh the potential risks.
If you're treated with antidepressants when breastfeeding, paroxetine or sertraline is normally recommended.
Children and young people
The use of antidepressants isn't usually recommended in children and young people under the age of 18. This is because there's evidence that, in rare cases, they can trigger thoughts about suicide and acts of self-harm in this age group.
Their use could affect the development of the brain in children and young people.
An exception can usually only be made if the following points are met:
- the person being treated has failed to respond to talking therapies like cognitive behavioural therapy, and
- the person being treated will continue to receive talking therapies in combination with antidepressants, and
- the treatment is supervised by a psychiatrist (a doctor who specialises in treating mental health conditions)
If an antidepressant is recommended, then fluoxetine is usually the first choice.
You should be wary of drinking alcohol if you're taking antidepressants. Alcohol itself is a depressant so it may make your symptoms worse.
If you drink alcohol while taking some types of antidepressants, you may become drowsy and dizzy.
The use of illegal drugs isn't recommended if you're taking antidepressants. This is because they can cause unpredictable and unpleasant effects.
In particular, you should avoid taking:
Illegal drugs can make symptoms of depression or other mental health conditions worse.
St John's Wort
St John’s Wort is a popular herbal remedy promoted for the treatment of depression.
While there's evidence of its effectiveness, many experts advise against its use. This is because the active ingredients varies among individual brands and batches. This can make the effects unpredictable.
Taking St John's Wort with other medications can also cause serious health problems.
You shouldn't take St John's Wort if you're pregnant or breastfeeding.
Some antidepressants can cause dizziness, drowsiness and blurred vision. These symptoms usually happen when you first start taking antidepressants.
If you do experience these problems, you should avoid driving, using tools or operating machinery.
You should never take 2 different types of antidepressants together. This is because taking certain combinations of antidepressants can make you feel very ill. It can also be life-threatening.
If your doctor decides to change your antidepressant, the dose of the first one will usually be gradually reduced before the second is given.
Side effects of antidepressants
Antidepressants can cause side effects at first, but these usually improve with time.
If you experience minor side effects, it's important to continue treatment. This is because it can take several weeks before you begin to benefit from treatment. With time, you should find that the benefits of treatment outweigh any side effects.
During the first few months of treatment, you'll usually see your doctor or a specialist nurse every 2 to 4 weeks. This will let them see how well the medication is working.
If you experience any severe side effects, you should let your specialist know.
For more information about your specific medication, see the patient information leaflet. This will be in the box with your medication.