I was 17 when a psychiatrist first put me on the antidepressant Prozac, which was actually being used to treat anxiety in my case. Prozac is a serotonin reuptake inhibitor (SSRI), which means it keeps the feel-good neurotransmitter serotonin around longer in your brain, theoretically leaving you happier. It did help alleviate some of my anxiety and constant irritability, but it also had a few side effects nobody told me about.
The first I noticed was that I suddenly found it much harder to orgasm, which was a bummer just as I was starting to explore my sexuality. Nobody told me this was a side effect of SSRIs, so I didn't know what was going on and wondered if there was something wrong with my body. The other main thing I noticed was that I was sleeping 10 hours a day and still in a mental fog. Again, I didn't connect the dots. I'd heard about college students' erratic sleep habits and assumed my own were somewhere within the normal range. It wasn't until I went off antidepressants that I realized how much they'd compromised my quality of life.
To avoid walking into it blindly like I did, it's important to know what the effects of antidepressants are, both positive and negative, before taking them and get proper care from a mental health professional. "Most antidepressants are prescribed by primary care MDs who don't have the training to deal with poor response or side effects," psychiatrist Soroya Bacchus, M.D. tells Bustle. "If your primary doctor started a medication and it's not working, see a psychiatrist."
It also helps to learn some of the facts. Toward that end, here are some things you may not have known about antidepressants, according to experts.
1. They Take A While To Work
If you don’t feel a difference after a few days or even weeks, don’t assume that your antidepressants aren’t working. It may take weeks or months for their effects to set in, Diana Graalum, PharmD BCPS, Clinical Pharmacy Manager of MedSavvy, tells Bustle. "For people with major depression, the right antidepressant should be taken for at least six months."
2. They Can Affect Your Sex Life
Antidepressants are actually sometimes used to treat premature ejaculation because they lead you to last longer, men’s sexual health expert Dr. Paul Turek tells Bustle. But for others, that means antidepressants can make reaching orgasm difficult or impossible. For some, they can also decrease sex drive. Talk to your doctor about switching medications if you have one of these side effects and it bothers you.
3. They Can Affect Your Bone Health
Since they prevent production and transmission of the neurotransmitter dopamine, leading to rises in prolactin and disruption of HPA axis activity, some antidepressants can increase your risk of osteopenia and osteoporosis, says Lara Pizzorno, MDIV, MA, LMT, author of Your Bones: How You Can Prevent Osteoporosis and Have Strong Bones for Life – Naturally. The longer you take the medication, the more your risk for these conditions increases.
“For anyone who needs to take antidepressants, it’s always recommended to discuss with your doctor the least harmful option,” says Pizzorno. “Working to understand the underlying cause of your health issues is critical, and can be done by working with an integrative, functional medicine, or naturopathic physician.”
4. They Can Cause Sleep Issues
People with anxiety, depression, and other conditions that may lead them to go on antidepressants often have trouble sleeping or sleep too much, Certified Sleep Science Coach Chris Brantner tells Bustle. Sometimes, treating these conditions will improve the patient's sleep. But other times, it can create sleep issues of its own.
"Antidepressants have been shown to not only lessen REM sleep, but prolong the time it takes you to enter REM sleep during your sleep cycles," Brantner says. "It's during this phase in which we're thought to consolidate memories and organize information. Poor REM sleep has also been linked to increased risk of Alzheimer's disease, and even symptoms of depression." It's also important to practice good sleep hygiene rather than expect antidepressants to do the work for you, Brantner says.
5. They're Hard To Come Off Of
"Most people don't realize that anti-depressants can be hard to come off of," psychotherapist Danielle Swimm, MA, LCPC tells Bustle. "People tend to experience withdrawal symptoms and have to taper off medication, experiencing flu like symptoms."
If you plan to go off antidepressants, it's important to come up with a plan with your psychiatrist to decrease them gradually rather than going full turkey, says Graalum.
6. You May Not Get It Right The First Time
Figuring out the right kind and dosage of antidepressant takes some trial and error. You may, for example, need to take a higher dosage, a different antidepressant, or another one in tandem with the one you're taking, says Graalum. Don't lose hope — it's all part of the process of finding the right treatment.
7. One In Nine Americans Use Them
Going on antidepressants doesn't make you abnormal. In fact, you're in good company: One in nine Americans use an antidepressant every month, clinical pharmacist Jolene R. Bostwick, PharmD, BCPS, BCPP tells Bustle. "Antidepressants are the third most commonly prescribed medication class," she says.
"We need to work to reduce the stigma of taking medications for mental health conditions," Bostwick says. "Perhaps we can continue to work to reduce stigma by discussing how commonly these agents are used."
There's no universal right or wrong answer to the question of whether or not to take antidepressants. Personally, I'm glad I went on them, but I'm also glad I went off them. If you think they might be for you, talk to a psychiatrist about what treatment plan makes the most sense for you.