Being prescribed antidepressants can feel like a really big deal - it might mean that you’re unsure whether or not you want to take them, especially if you don’t understand how they’ll affect you. We spoke to Dr Lars Davidsson, psychiatrist and medical director of the Anglo European Clinic, to find out what you should know before you start.
Being prescribed antidepressants by a GP
You went to see your GP about feeling low, or anxious, and you’ve come out with a prescription for antidepressants. How you feel about taking them will depend on what happened in that appointment, and the information you’ve been given. Psychiatrist Dr Lars Davidsson says it’s important the following happened:
- You felt listened to and understood
- They asked you in detail about your thoughts and feelings
- You were given a diagnosis
- You were offered CBT or another form of talking therapy alongside your medication
- The side-effects of the medication and how long it takes for it to work were thoroughly explained to you
“If a doctor has recommended you take antidepressants then my opinion is yes, you should probably take them,” says Dr Lars. “But you should also be referred to get some kind of therapy alongside the prescription too.”
Why is a diagnosis of depression important?
“In instances of mild depression, you shouldn’t be prescribed antidepressants at all, but offered some kind of CBT,” says Dr Lars. “If you have moderate depression, you should be prescribed both therapy and antidepressants.”
What if I’m offered antidepressants but no therapy?
If you’re happy enough with being prescribed antidepressants and are happy to take them, then you needn’t worry about therapy. However, if you feel that some kind of therapy will be more helpful to you long term, then it’s best to discuss this with your GP so that you can understand the options available to you.
“There’s really no reason why you should be advised to just take medication with nothing alongside it,” says Dr Lars. “If that happens, it’s usually down to a lack of resources or the GP’s lack of experience. Don’t be afraid to ask to be referred to a psychiatrist.”
What are the side-effects of antidepressants?
There’s evidence that a type of antidepressant called SSRIs can have worse side-effects (including causing suicidal thoughts) for young people, pregnant women and women who are breastfeeding. SSRIs, such as Fluoxetine, are regularly used for depressive disorders.
Your doctor will be aware of this, and should prescribe you with a suitable medication, and they’ll tell you about any possible side-effects and what you can expect. Some people take antidepressants and have no trouble, but others find they:
- Feel sick
- Feel sleepy
- Feel even more depressed
It’s important to bear in mind that you can experience side-effects within days of starting treatment, but it usually takes at least a couple of weeks for the medication to start working.
You should also have a follow up appointment to discuss whether they’re working for you. If you feel suicidal, speak to your GP, go to A&E, or contact the Samaritans.
Will they affect my sex life?
Antidepressants might affect your sex life. A common side-effect is losing your ability to reach orgasm if you’re a girl, and ejaculate if you’re a boy. This doesn’t happen to everyone though, and you can ask your doctor to change you to a different type of antidepressant if you’re experiencing these symptoms.
“Not every type of antidepressant is the same,” says Dr Lars Davidsson, psychiatrist and medical director of the Anglo European Clinic. “If they’re affecting your sex life you can always ask your doctor to swap to a different one. And, remember that depression itself is a massive libido killer. Give your drugs a month or so to start working before you declare they’re putting you off sex.”
Can I drink alcohol?
Medical advice suggests that you shouldn’t drink alcohol whilst on antidepressants, as the booze lessens the impact of them. Alcohol can increase the side effects that the antidepressants are meant to be helping, such as drowsiness. But according to Dr Lars there’s room for a tiny bit of give.
“You absolutely can’t get drunk on them,” he says, “but you should be able to have a pint or two, a glass of wine here and there, but it has to be a very modest amount. Whatever you do though, don’t mix them with drugs like cocaine or cannabis.”
Do they cause weight gain?
Antidepressants can cause some weight gain, but this usually isn’t much. Because depression oftentimes leads to a person not really feeling hungry, you may eat more once the antidepressants start to work properly.
“Depressed people tend to eat less as nothing tastes any good and you don’t get hungry,” says Dr Lars. “So some people gain weight just because they’re eating more and feeling better.”
If you’re worried about putting weight on, try and eat more healthily, or up your exercise. If it’s really a problem, go back to your GP and ask about changing your prescription.
Do they make you feel numb?
“This is one of the most common misconceptions about antidepressants,” says Dr Lars. “But they work by lifting your mood, not my numbing you down and taking away all your feelings.”
It can take up to six weeks before you notice the drugs working, in which time you’ll still have depressive symptoms, such as feeling withdrawn and numb. But this is the depression, not the drugs, which need time to kick in.
If you’re taking antidepressants to treat anxiety, you may feel ‘number’ when actually you’re just feeling less anxious and wound up.
Alternatives to antidepressants
If your doctor has prescribed you with antidepressants, then it’s likely that they feel this is the best way to help you at that time. There are some alternatives that you might try over time, although these can work better if you’re on medication, according to Dr Lars. Some of the most common options if you don’t want to take antidepressants are:
- Talking therapies such as Cognitive Behavioural Therapy (CBT)
- Adopting a healthy diet
- Upping your levels of exercise
- Getting more sleep and in a regular pattern
Should I take antidepressants?
It’s an entirely personal decision, but if you’ve been prescribed them, it is recommended. “At the end of the day, it’s up to you,” says Dr Lars. “But if the doctor prescribed you medicine for diabetes or low blood pressure, would you not take the medicine for that? I guess it comes down to ‘do you want treatment?’”
By Holly Turner
Updated on 27-Mar-2021
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