Antidepressants are a class of medications primarily used to treat clinical depression, as well as various anxiety disorders and other mental health conditions (Malhi et al. 2021). Although they can alleviate symptoms—such as persistent low mood, hopelessness, or anxious distress—taking antidepressants can also bring about certain side effects and requires careful monitoring. This article outlines how antidepressants work, how they may affect the body and mind, and what individuals should consider when using them as part of a broader mental health treatment plan.
Keywords: What happens when you take antidepressants, Antidepressant side effects, SSRIs and SNRIs, Depression and medication, Psychological therapies, Mental health medication management
1. Defining Antidepressants and Their Roles
1.1 Types of Antidepressants
Several main classes of antidepressants are commonly prescribed in Australia, each operating via slightly different chemical mechanisms (Royal Australian and New Zealand College of Psychiatrists [RANZCP] 2022):
- Selective Serotonin Reuptake Inhibitors (SSRIs): e.g., sertraline, fluoxetine.
- Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs): e.g., venlafaxine, duloxetine.
- Tricyclic Antidepressants (TCAs): e.g., amitriptyline, nortriptyline (older class, sometimes used for specific cases).
- Monoamine Oxidase Inhibitors (MAOIs): e.g., phenelzine, tranylcypromine (less commonly prescribed due to dietary restrictions).
- Atypical Antidepressants: e.g., mirtazapine, agomelatine (varying mechanisms).
1.2 Purpose and Effectiveness
Antidepressants can help correct chemical imbalances in the brain associated with depressive symptoms, boosting mood, motivation, and overall emotional stability (Malhi & Mann 2018). However, they are generally one component of a holistic treatment approach that may also involve psychotherapy, lifestyle changes, and social support (Beyond Blue 2023).
2. How Antidepressants Work in the Brain
2.1 Neurotransmitter Regulation
Depressive symptoms have been linked to dysregulated levels of neurotransmitters—including serotonin, noradrenaline, and dopamine (Malhi & Mann 2018). Antidepressants typically function by inhibiting the reuptake of these chemicals, enhancing their availability in neural synapses, or modifying their breakdown pathways. This increased neurotransmitter activity can, over time, reduce the intensity of depressive or anxious symptoms (RANZCP 2022).
2.2 Time Course for Effects
While some individuals report mild mood improvements within the first couple of weeks, therapeutic effects of antidepressants often take 4–6 weeks (or even longer) to manifest fully (Malhi et al. 2021). Physiological changes in synaptic receptor sensitivity and brain plasticity processes can explain this delay.
2.3 Variation in Individual Response
Not everyone responds identically to a given antidepressant (Galletly et al. 2020). Individual genetics, overall physical health, and the presence of co-existing mental health conditions can influence both effectiveness and side effect profiles. Finding the most suitable medication might involve some trial and error under close medical supervision.
3. Potential Benefits of Taking Antidepressants
3.1 Symptom Relief
For many people experiencing moderate to severe depression, antidepressants can ease core symptoms such as persistent sadness, low energy, and pervasive feelings of guilt or worthlessness (Malhi et al. 2021). Alleviation of these symptoms can foster a more stable emotional environment, supporting re-engagement with daily activities and personal relationships.
3.2 Improved Functioning
Effective treatment can enable individuals to regain lost functionality—whether attending work or school, maintaining social connections, or fulfilling caregiving responsibilities (Beyond Blue 2023). As antidepressants restore a measure of emotional balance, psychological therapies often become more fruitful, enabling deeper work on underlying issues.
3.3 Potential Anxiety Reduction
Certain antidepressants—particularly SSRIs and SNRIs—are commonly prescribed for anxiety disorders (RANZCP 2022). By calming overactive neural circuits tied to anxious rumination, these medications can help reduce panic symptoms, obsessive thinking, or severe social anxiety.
4. Common Side Effects and Safety Considerations
4.1 Initial Adjustment and Physical Effects
Antidepressants can produce side effects, especially during the early stages of treatment. Examples include:
- Gastrointestinal Symptoms: Nausea or upset stomach (SSRIs).
- Sleep Changes: Insomnia or sedation, depending on the medication’s mechanism (TCAs may cause sedation).
- Headaches and Dizziness: Mild but can subside within weeks (Malhi et al. 2021).
4.2 Sexual Dysfunction
Many antidepressants, particularly SSRIs, can affect libido, arousal, or orgasmic function (RANZCP 2022). Patients should feel comfortable discussing sexual side effects with their prescriber, as dose adjustments or medication changes can mitigate such concerns.
4.3 Emotional Numbing or Blunting
Some individuals experience a “flattening” of emotional range, feeling less sadness but also reduced joy (Malhi & Mann 2018). This side effect varies; if it significantly diminishes quality of life, consulting a mental health professional about alternative treatments may be beneficial.
4.4 Risk of Increased Suicidal Ideation
In younger populations (under 25), there may be a small but notable rise in suicidal ideation or behaviour when starting antidepressants (Galletly et al. 2020). Vigilant monitoring by healthcare providers and support networks is critical during this initial phase.
5. Ensuring Proper Use and Monitoring
5.1 Regular Consultations with Healthcare Providers
Routine check-ups enable adjustments in medication type or dosage if side effects prove intolerable or efficacy is suboptimal (RANZCP 2022). Open communication about mood changes, daily function, and any troubling symptoms is key to refining treatment.
5.2 Adherence to Prescription Guidelines
Stopping antidepressants abruptly can cause discontinuation syndrome, marked by dizziness, irritability, or flu-like sensations (Malhi & Mann 2018). Gradual tapering—under a clinician’s guidance—helps mitigate withdrawal effects and fosters a smoother transition if changing medications.
5.3 Combining Medication with Psychotherapy
Evidence suggests that integrated approaches—e.g., cognitive-behavioural therapy (CBT) alongside medication—often yield the most robust and sustainable improvements for moderate to severe depression (Beyond Blue 2023). Incorporating counselling or support groups can enhance coping skills, address core emotional issues, and prevent relapse.
6. Alternative and Adjunctive Treatments
6.1 Lifestyle Interventions
Regular exercise, balanced nutrition, and sufficient sleep can complement antidepressant therapy, boosting overall resilience (Galletly et al. 2020). These lifestyle factors modulate stress responses and neurochemical pathways critical to mood regulation.
6.2 Mindfulness and Stress Management
Techniques such as mindfulness meditation, yoga, or relaxation exercises reduce anxiety and stress hormone levels, possibly enhancing medication outcomes (Malhi & Mann 2018). Structured programs like mindfulness-based cognitive therapy (MBCT) can deter depressive relapse.
6.3 Complementary Supplements
While the evidence for supplements such as omega-3 fatty acids or St John’s Wort remains varied, some individuals report mild symptom relief (RANZCP 2022). However, interactions between supplements and antidepressants necessitate caution and professional guidance.
Conclusion
Antidepressants, when prescribed and monitored responsibly, can substantially alleviate depressive and anxiety symptoms—allowing individuals to reclaim daily functioning and restore a sense of well-being (Malhi et al. 2021). Yet, they are not a “one-size-fits-all” solution. Finding the right medication, dosage, and duration involves close collaboration between patients and healthcare professionals. Regular reviews, transparent communication about side effects, and the integration of psychotherapy or lifestyle changes can optimise the benefits of antidepressant treatment, fostering a more stable emotional landscape for recovery.
References
- Beyond Blue 2023, Treatments for Depression: Medication and Psychological Therapies, Beyond Blue, viewed 7 February 2025, https://www.beyondblue.org.au/.
- Galletly, C., Castle, D., Dark, F., et al. 2020, ‘Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines for the Management of Mood Disorders’, Australian & New Zealand Journal of Psychiatry, vol. 54, no. 8, pp. 852–888.
- Malhi, G.S. & Mann, J.J. 2018, ‘Depression’, The Lancet, vol. 392, no. 10161, pp. 2299–2312.
- Malhi, G.S., Bell, E., Singh, A.B., et al. 2021, ‘The 2020 Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines for Mood Disorders: Major Changes and Clinical Implications’, Australian & New Zealand Journal of Psychiatry, vol. 55, no. 1, pp. 8–9.
- Royal Australian and New Zealand College of Psychiatrists (RANZCP) 2022, Practice Standards on the Use of Antidepressants, RANZCP, viewed 7 February 2025, https://www.ranzcp.org/.
- Sarwer, D.B., Gibbons, L.M. & Crerand, C.E. 2019, ‘Body Image and Quality of Life in Aesthetic Surgery’, Aesthetic Surgery Journal, vol. 39, no. 3, pp. 265–270.
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