Monitoring side effects can help you track patterns, manage any discomfort, and identify issues that may require adjustments.

Starting a new antidepressant can bring relief, but it’s important to understand that side effects may occur as your body adjusts.

Common effects like nausea, headaches, or mild dizziness are often temporary and subside over time. However, some symptoms may require more attention if they persist or worsen.

Monitoring these effects by keeping a journal and discussing them with your doctor can help ensure your treatment stays safe and effective.

Here are some common side effects of new antidepressants:

  • Nausea: feeling sick to your stomach, especially during the first few days
  • Headaches: mild to moderate headaches as your body adjusts
  • Dizziness: feeling lightheaded or unsteady, especially when standing up quickly
  • Insomnia: difficulty falling or staying asleep
  • Weight gain or loss: changes in appetite leading to weight changes
  • Sexual dysfunction: issues like reduced libido or difficulty achieving orgasm
  • Fatigue: feeling unusually tired or lacking energy
  • Dry mouth: a sensation of a dry or cotton-like feeling in your mouth
  • Increased anxiety or agitation: feeling more restless or anxious, particularly early in treatment
  • Brain zaps: a sudden, electric shock-like feeling in the brain (sometimes reported during withdrawal)

Warning signs that require medical attention

These could indicate an adverse reaction or a serious issue:

  • Severe mood changes: such as worsening depression or thoughts of self-harm
  • Allergic reactions: rash, itching, or swelling could signal an allergy
  • Heart issues: palpitations, chest pain, or fainting
  • Uncontrollable restlessness: feeling agitated or unable to stay still

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

These monitoring strategies help you stay on top of any side effects, ensuring you can address any issues early and work with your healthcare professional to manage them.

  • Keep a journal: Track the date, time, symptoms, and medication dosage in a simple format. Note physical symptoms (like nausea or dizziness), mood changes, sleep quality, energy levels, and cognitive effects. Reviewing your journal regularly can help identify patterns, triggers, and progress.
  • Track sleep and energy levels: Pay close attention to changes in sleep patterns and energy. Track how much sleep you’re getting and how you feel throughout the day. Significant changes in sleep or fatigue can be an early indicator that your body is reacting to the medication.
  • Regular check-ins with your doctor: Schedule routine appointments to review your progress. Bring your symptom journal and any concerns you’ve noted. Your doctor can assess if your side effects are typical, offer adjustments, or refer you for further treatment if necessary.
  • Get blood work done: Some antidepressants can affect your body’s chemical balance. Periodic blood tests help monitor how the medication is interacting with your system, such as checking liver function, blood sugar levels, or electrolyte imbalances.
  • Be patient: Understand that side effects can take time to subside. It’s common for your body to need 2 to 4 weeks to adjust to a new medication. While some side effects are temporary, others may persist longer, so it’s important to give your body time to adapt.

Early side effects may predict treatment outcomes

Monitoring side effects early in treatment may be important for predicting how well the treatment will work.

One studyTrusted Source looked at the severity of side effects from antidepressants and how they relate to treatment outcomes in people with major depressive disorder (MDD). Over 1,000 adults were treated with one of three antidepressants:

  • escitalopram
  • sertraline
  • venlafaxine

Researchers found that side effects were most severe around two weeks after starting treatment and then gradually decreased by week 6.

The study found that while side effects decreased over time, a higher burden of side effects early on (within the first few days) was linked to poorer treatment outcomes.

Another studyTrusted Source looked at why people stop taking antidepressants and what factors influence their decisions.

While side effects like sexual problems and weight gain didn’t increase the likelihood of stopping the medication, issues like anxiety, agitation, suicidal thoughts, vomiting, and rashes did. People with conditions like post-traumatic stress disorder (PTSD) or attention deficit hyperactivity disorder (ADHD) were also more likely to stop treatment.

The study found that the highest discontinuation rates were for mirtazapine (Remeron), a tetracyclic antidepressant, and amitriptyline (Elavil), a tricyclic antidepressant (TCA).

  • Start with a low dose: Begin with a lower dose to help your body gradually adjust and reduce the intensity of side effects. Consult your doctor about increasing the dose over time.
  • Take your medication at the same time daily: Consistency helps reduce side effect fluctuations and helps establish a routine.
  • Monitor your sleep: To manage insomnia or excessive tiredness, create a calming bedtime routine, reduce screen time, avoid caffeine, and stick to a consistent sleep schedule.
  • Exercise regularly: Engage in light exercise, like walking or gentle yoga, to combat fatigue, improve mood, and reduce tension. Research suggests that exercise, when paired with antidepressant medications, can help improve the main symptoms of depression and boost cognitive function.
  • Practice relaxation techniques: Use deep breathing, meditation, or progressive muscle relaxation to manage anxiety, agitation, or irritability.
  • Eat small, frequent meals: Opt for smaller meals throughout the day to manage nausea and avoid heavy, greasy foods that can irritate your stomach.
  • Stay hydrated: Drink plenty of water to alleviate dry mouth, dizziness, and headaches and to help with fatigue and muscle aches.

Can antidepressant dosages be adjusted to manage side effects?

Yes, antidepressant dosages can be adjusted to help manage side effects. If you’re experiencing discomfort, your doctor might lower your dose or gradually increase it. In some cases, your doctor may recommend switching to a different medication or adding another treatment to help with side effects.

Always talk with your doctor before making any changes to ensure it’s done safely.

It’s important to talk with your doctor about side effects, especially if they’re severe, persistent, or affecting your daily life.

If you experience symptoms like extreme fatigue, thoughts of self-harm, or a sudden change in mood, seek help right away.

You should also speak with a doctor if side effects persist after a few weeks or if you’re unsure how to manage them.

Beginning a new antidepressant can offer relief, but it’s essential to carefully monitor any side effects. Keep a journal of your symptoms, including their severity and when they happen.

Remember, some side effects improve over time, but if they persist or are severe, contact your doctor for further guidance.