Sexual dysfunction to insomnia: How antidepressants can do more bad than good

Certain antidepressants may disrupt sleep patterns, causing insomnia, frequent waking, or excessive daytime sleepiness. (Image: Canva)

Antidepressants are medications primarily used to treat depression, though they may also help manage anxiety disorders, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and other mood disorders. They work by altering neurotransmitter levels in the brain, particularly serotonin, norepinephrine, and dopamine, which regulate mood, emotions, and behaviour. Antidepressants come in various classes, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and others.

However, Antidepressants, like all medications, can have potential side effects, though their severity and occurrence vary widely among individuals. Here are some potential harmful effects according to Delhi-based clinical psychologist Rahul Kanwar.

Nausea and digestive issues: Many antidepressants can cause gastrointestinal disturbances such as nausea, vomiting, diarrhea, or constipation. These symptoms can vary in severity and may improve over time as the body adjusts to the medication.

Weight gain or loss: Antidepressants can alter appetite and metabolism, leading to weight gain or loss. Weight changes can affect self-esteem and overall health, requiring monitoring and possibly dietary adjustments or additional medications.

Sexual dysfunction: A common side effect includes decreased libido, difficulty reaching orgasm, or erectile dysfunction. These issues can significantly impact quality of life and relationships, necessitating open communication with healthcare providers for management options.

Insomnia or sleep disturbances: Certain antidepressants may disrupt sleep patterns, causing insomnia, frequent waking, or excessive daytime sleepiness. Improving sleep hygiene and adjusting medication timing can help mitigate these effects.

Fatigue and drowsiness: Feeling excessively tired or drowsy during the day is common with some antidepressants. This can impair daily functioning and require adjustments in dosage or timing under medical supervision.

Anxiety or nervousness: Initially, antidepressants may increase anxiety or nervousness before symptoms improve. Close monitoring during the early stages of treatment is crucial to manage these temporary effects.

Increased risk of bleeding: Certain antidepressants can interfere with blood clotting mechanisms, potentially leading to increased bruising or bleeding. This risk is heightened in individuals taking blood-thinning medications or with underlying clotting disorders.

Dependency: Abruptly stopping antidepressants can lead to withdrawal symptoms such as flu-like symptoms, mood swings, dizziness, or sensory disturbances. Gradual tapering under medical supervision helps minimise these effects.

Serotonin syndrome: Rare but serious, serotonin syndrome can occur when serotonin levels become dangerously high. Symptoms include rapid heartbeat, high blood pressure, fever, agitation, and confusion, requiring immediate medical attention.

It's important to note that not everyone experiences these side effects, and the benefits of antidepressants often outweigh the risks for many people with depression or anxiety disorders. Always consult with your doctor to discuss potential side effects and determine the best treatment approach.