Antidepressants: Types, Uses, Side Effects, And More

By Chris Bodle, MD
Medically reviewed
June 16, 2021

Depression is a common medical condition, impacting 322 million people worldwide. While depression is most commonly known for feelings of sadness, it can come with plenty of other symptoms that can interfere with your moods, physical well-being, and relationships.

It is so important that people with depression seek support and sometimes that support comes in the form of antidepressants. Your doctor’s approach to treatment will depend on the severity of your symptoms and your preferences. Effective options include lifestyle changes, psychotherapy, and medication, and these can be used together. 

There are several ways to treat depression, and how your doctor treats yours depends on the severity of your symptoms. Both lifestyle changes and psychotherapy are effective ways to treat depression. Another way to treat depression is with medication.

Antidepressants can balance your brain chemistry to improve depression symptoms. According to one study, about 40-60 people out of 100 people who took an antidepressant reported improved symptoms within 6-8 weeks. Your doctor can help you determine if antidepressants are right for you.

For many people, antidepressants are a game-changer, yet there’s also a lot of misinformation out there. In this article, I’ll explain what depression is, common medications including antidepressants, alternative treatment options, and if you can get antidepressants over the counter or online. With the help of a healthcare professional, you can find the best treatment for you and learn to manage or overcome your depression.

What Is Depression?

Affecting one in 15 adults in any given year, depression is a mood disorder that can interfere with your daily life. Depression can occur in anyone, but it’s more common in women. Research increasingly shows that people who identify as sexual and gender minorities are also at increased risk for depression. 

Despite the stereotype that depression just makes you sad all the time, this condition can manifest differently in different people. Common symptoms of depression include:

  • Sadness or a depressed mood
  • Loss of interest in activities you once enjoyed
  • Changes in appetite
  • Sleep disruption—sleeping too much or trouble sleeping
  • Lack of energy or increased fatigue
  • Feelings of hopelessness or guilt
  • Difficulty thinking and making decisions
  • Irritability or restlessness
  • Thoughts of suicide or self-harm

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Types of Depression

Under the umbrella of depression, there are also several subtypes that can cause different symptoms. It’s important to talk to a doctor or behavioral health professional to understand what kind of depression you have so you can get the right treatment.

  • Major depressive disorder (MDD): MDD is a type of clinical depression that causes people to feel depressed most days of the week.
  • Bipolar disorder: Previously known as “manic depression,” bipolar disorder causes mood episodes that range from extremes of high energy with an “up” mood to low “depressive” periods. Symptoms of major depression arise during the low phase.
  • Seasonal affective disorder (SAD): SAD is a period of major depression more likely to occur during the winter months, when the days are shorter and there is less sunlight.
  • Postpartum depression (PPD): PPD is a type of depression that sometimes occurs in women after they give birth. Some women also experience depression symptoms during pregnancy.
  • Premenstrual dysmorphic disorder (PMDD): Often accompanied by other premenstrual symptoms like anxiety, irritability, and fatigue, PMDD is a type of depression some women experience before or at the start of their periods.

What Are Antidepressants?

Antidepressants are prescription medications used to alleviate symptoms of depression. For people with depression, the condition is bigger than just a “bad day” or a “negative attitude” (unfortunate stereotypes that people sometimes apply). Depression can alter the brain chemistry, resulting in lower levels of the essential hormones—serotonin, norepinephrine, and dopamine—that keep you feeling your best. 

How do antidepressants work? 

Antidepressants work by balancing certain chemicals in your brain that are responsible for regulating your well-being. 

The most common type of antidepressants are selective serotonin reuptake inhibitors or SSRIs, which work by increasing the level of serotonin in your brain. Some refer to serotonin as the “happiness hormone” because of its role in regulating mood, emotions, and sleep. SSRIs block the nerve cells from absorbing serotonin, leaving the hormone available to send messages to other neurons. 

Another category of antidepressants called serotonin and norepinephrine reuptake inhibitors (SNRIs) works on both serotonin and norepinephrine. Lastly, other types of medications like tricyclic antidepressants are less common but still prescribed for some people. 

Do antidepressants really work?

Depression can be difficult to pinpoint because it manifests differently in everyone, and there is no clearly identifiable cause. That said, antidepressants can be an effective treatment. According to studies on adults, using an antidepressant rather than a placebo helps an extra 20 out of 100 people who have moderate or severe depression.

However, SSRIs and other antidepressants aren’t the perfect solution for everyone. It may take a few tries to find an antidepressant that works well for you, and medication isn’t an automatic fix. That’s why it can help to use a multi-pronged approach, including psychotherapy and lifestyle adjustments, to treat depression.

Types of Antidepressants

Since depression can be the result of a chemical imbalance in the brain, your doctor may treat your symptoms with an antidepressant medication. Antidepressants generally work by adjusting levels of neurotransmitters (signaling chemicals in the brain), but each drug works differently. There are five classes of depression medications your doctor may prescribe you:

Selective serotonin reuptake inhibitors (SSRIs)

The most commonly prescribed antidepressants, SSRIs, usually have fewer undesirable side effects than other antidepressant medications. SSRIs work by blocking the removal of serotonin from the brain and thereby increasing serotonin levels. The increase in serotonin can help the brain cells send and receive messages more efficiently, and this can result in a better mood.

Serotonin and norepinephrine reuptake inhibitors (SNRIs)

Similar to SSRIs, SNRIs help balance brain chemistry by blocking the removal of neurotransmitters. Rather than just increasing serotonin levels, SNRIs also increase norepinephrine, which impacts how brain cells communicate.

Monoamine oxidase inhibitors (MAOIs)

Though they are less commonly prescribed now, doctors frequently prescribed MAOIs before the advent of SSRIs and SNRIs. MAOIs inhibit a brain enzyme called monoamine oxidase, which breaks down serotonin and other neurotransmitters. The end result is similar to SSRI and SNRI medications; an increase in serotonin, norepinephrine, and other neurotransmitters. However, MAOIs interact with many other medications and foods, so they are usually used as a second line medication when people are not responding to other treatments.

Tricyclic antidepressants (TCAs)

Tricyclic antidepressants are another, older type of antidepressant. While they are known to cause more severe side effects in some people, TCAs can help manage depression by blocking the removal of neurotransmitters, serotonin and norepinephrine, ultimately increasing their levels in the brain. They are called “tricyclic” antidepressants because there are three rings in their chemical structure.

Atypical antidepressants

In some cases, a doctor might prescribe an atypical antidepressant like Wellbutrin (bupropion). They are so named because they don’t fit into any other antidepressant class—each atypical antidepressant is unique and works differently. As with other antidepressants, atypical medications ease depression symptoms by altering brain chemistry.

Antidepressant Uses

Along with treating depression, antidepressants are also approved to help people with a number of other conditions, including:

Studies show that 29% of antidepressant use is for “off-label use,” which means a doctor may prescribe them to treat conditions like insomnia, pain, or migraines.

Common Depression Medications

Depending on factors like your symptoms, current medications, and health history, along with potential side effects, your doctor may prescribe any of the below antidepressants for your depression. The medications are listed with a brand name and followed by the generic name.

SSRIs

SNRIs

MAOIs

  • Parnate (tranylcypromine)
  • Nardil (phenelzine)
  • Marplan (isocarboxazid)

Tricyclic antidepressants

  • Tofranil (imipramine)
  • Pamelor (nortriptyline)
  • Elavil (amitriptyline)
  • Norpramin (desipramine)

Atypical antidepressants

  • Wellbutrin (bupropion)
  • Remeron (mirtazapine)
  • Trintellix (vortioxetine)

What to Know Before You Take Antidepressants

There are a few things to keep in mind if you’re considering trying an antidepressant:

  • You’ll likely experience relief from depression medication, but it usually takes a few weeks before you notice any positive effects. 
  • You may need to work with your doctor to find the medication that works best for you. 
  • If you notice undesirable side effects, tell your doctor.
  • Some depression medications have withdrawal symptoms. If you plan to stop an antidepressant or if you’re experiencing symptoms of antidepressant withdrawal, talk to a doctor.

How do you know if you need an antidepressant?

If you are experiencing symptoms consistent with clinical depression—persistent sadness, loss of interest in activities you used to enjoy, changes in appetite, sleep disruption, lack of energy, feelings of hopelessness, irritability, inability to make decisions, and/or thoughts of suicide or self-harm—see a doctor. They may prescribe an antidepressant. If you are having suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-8255.

How long does it take for antidepressants to work? 

You typically need to take a new antidepressant for a few weeks to notice changes in your mood. If you don’t feel a difference after a month or so, talk to your doctor. They may recommend changing medications. Unfortunately, it can take a few tries to find the right antidepressant for you, but it’s worth continuing to try until you do.

Depression Medication Side Effects

Antidepressant side effects vary based on the medication’s class. Some side effects are temporary and go away after a few weeks. Others are more likely to persist the whole time you are on the antidepressant. Keep in mind, not everyone experiences side effects, and it’s unlikely to experience all of them. Commonly reported antidepressant side effects include:

  • Nausea
  • Increased appetite, which can cause weight gain
  • Insomnia
  • Fatigue or tiredness
  • Dry mouth
  • Blurred vision
  • Dizziness
  • Irritability
  • Anxiety
  • Loss of sexual desire or inability to orgasm

If any side effects bother you, talk to your doctor. They will work with you to determine whether these negative effects outweigh the potential benefits of an antidepressant or if you should try another option. 

Do antidepressants cause weight gain?

Depression itself can cause weight gain or loss due to changes in appetite. Additionally, most antidepressants list weight gain as a potential side effect. This doesn’t happen to everyone, but if you do experience a significant gain, your doctor can recommend a new antidepressant that may not affect your weight.

Why do antidepressants sometimes cause suicidal thoughts?

In rare cases, the changes in brain chemistry caused by antidepressants can backfire, leading to severe mood changes that worsen depression, violent thoughts, or thoughts of self-harm. If this happens, call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255. You will need to alter your treatment plan with the help of your doctor. 

Alternative Treatment Options

Medication can be a helpful tool for your mental health, but it’s not the only line of treatment for depression. Other evidence-based practices can also help manage your depressive symptoms, whether or not you’re taking antidepressants:

Can You Get Antidepressants Over the Counter?

Antidepressants are only available by prescription, so you cannot buy them over the counter. Since depression shows up differently in every person, doctors need to be able to adjust their treatment recommendations and follow up with patients to see how they’re doing. This keeps you safe and minimizes your chances of negative side effects. 

Can You Get Antidepressants Online?

You can, however, get antidepressants online. You still need to see a licensed provider who can give you a prescription. With that, you can order your medication from a licensed online pharmacy. Or here at K Health, our doctors can immediately chat with you any day of the week and, if they prescribe antidepressants, we can ship them directly to you. 

How much do antidepressants cost?

The cost of antidepressants varies depending on the type of medication and your insurance coverage. The good news is that most health insurance plans cover antidepressants, bringing the cost down to only a few dollars each month. 

At K Health, we know insurance can be a headache. That’s why we’ve made it our mission to provide quality care for everyone at the same price: $12 per visit or $9 per month for unlimited visits, and both options give you access to medications.

When to See a Doctor

It’s normal for people to experience a low mood every now and then. If you find your depression symptoms are interfering with your daily life, or if they persist for more than a week or two, it’s important to talk to a doctor about your symptoms. It can be hard to admit you’re struggling, however it is important to realize you are not alone. Depression is a common condition, and the medical community is well equipped to help. Seeking support will ensure you get the care and treatment you need to feel better.

It’s also important to reach out to your doctor if you want to stop or change a medication for anxiety or depression, or manage side effects.

Contact a medical professional immediately if you have any thoughts of suicide or self-harm. The National Suicide Prevention Hotline is available 24 hours a day and can be reached at 1-800-273-8255.

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How K Health Can Help

Anxiety and depression are among the most under-reported and under-treated diseases in America. Nearly 20% of adults in the U.S. suffer from mental health illness and fewer than half receive treatment. Our mission is to increase access to treatment for those suffering in silence.

You can start controlling your anxiety and depression and get access to the treatment you need with K Health. Starting at $12/month get prescriptions for mental health medications plus unlimited doctor visits through the K Health app. Start your free assessment here.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Chris Bodle, MD

Dr. Bodle is a board certified emergency medicine physician. He received his medical degree from Indiana University School of Medicine, and completed his residency in emergency medicine at Emory University. In addition to K Health, he currently works as an Emergency Medicine physician in an Urban, Level 1 Trauma Center in the south east.