Experiences of antidepressants

Using an antidepressant -SSRIs (Selective Serotonin Reuptake Inhibitor)

SSRI (Selective Serotonin Reuptake Inhibitor) are currently the most widely prescribed type of antidepressants. They are usually prescribed first over other antidepressants as side effects may be better tolerated than the older antidepressant medicines, and they cause less harm in overdose. It is thought that they relieve depression by altering the way that chemicals (called neurotransmitters) work in our brains to transmit signals between cells. SSRI’s are typically used to treat moderate to severe depression. It is difficult to know how a person will respond to any particular medicine, and it usually takes a number of weeks to know whether it works. Some people need to try several before they find one that suits them. Some may find that SSRI s don’t work for them, and may be prescribed a different type of antidepressant.
 
The most commonly prescribed SSRIs are:
  • citalopram (Cipramil)
  • fluoxetine (Prozac)
  • paroxetine (Seroxat)
  • sertraline (Lustral)
 
As with all medicines, antidepressants can be known by different names (the trade name or the generic name). People we spoke to referred to both, or either, at different times. Some did not realise for example, that when they had been prescribed fluoxetine, it was Prozac.
 
(For information on other types of antidepressants see 'Tricyclic antidepressants and SNRIs, Mirtazapine & MAOIs').
 
The majority of the people we interviewed had taken an SSRI at some point. Some had tried more than one, or several at different times. They described a wide range of effects ranging from positive to negative. At one end of the spectrum some said they felt ‘fantastic’, ‘consistently happy’, or ‘back to normal’ when they were taking an SSRI. Caroline described how paroxetine (Seroxat) worked for her, "suddenly it was like, just like having somebody sort of taking charge of you lifting you up". She explained that she still feels down sometimes even on an antidepressant but said "I’ve certainly had dips but I think I’ve always managed to get over them I’ve never, I’ve never got in that downward spiral." 
Sharon said that taking fluoxetine made life more manageable by reducing her symptoms "it takes the edge off of my feelings to help me... feel, I don't like to say ‘normal’, but to feel ‘normal’ emotions in a normal range... and I've got control back." Lou calls sertraline "my perspective tablets" and feels they help her to see things in a more positive way. 
Some people noticed differences in the way they responded to different SSRIs or even to the same SSRI when taken on different occasions. Not everyone knew why their doctor had prescribed one particular SSRI over another, but some said their doctor had prescribed one because it was particularly suitable to help with specific symptoms, such as anxiety or sleep problems. Some felt that doctors had favourites, or suspected that they prescribed the cheapest rather than the most effective. 
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Sometimes people experienced contradictory effects, feeling better in some respects, but worse in others. Rachel has tried several different SSRIs over the years which sometimes have ‘lifted’ her mood, but the disadvantage is that she can feel distant, numb and unable to experience emotions. ‘You’re making it through the day but you’re not living, you’re not being you’. Rachel still experiences depressive symptoms whilst taking an antidepressant but some days are better than others; at times she has stopped taking her antidepressant because she doesn’t like how it makes her feel. 
Like Rachel, others also said they had felt ‘detached’ when they were taking an SSRI. The extent to which this could be tolerated varied. Emily didn’t mind too much because she felt it made it easier to develop a clearer perspective on her life. Tim said he felt ‘a sense of distance from the world a bit... kind of like what was happening wasn’t really happening’ Often these feelings lessen over time. 
Positive benefits also sometimes seemed less apparent after a while. Some people, even those who had tried several types, said they felt no benefits at all from taking an SSRI. Thomas took citalopram for about a year but eventually decided to stop because ‘I couldn’t think that it had improved my mood. It hadn’t done anything for me.’ Over a period of several years Roisin tried a variety of different SSRIs but said that ‘nothing seemed to work’. Some people may find that they respond more positively to another type of antidepressant (see 'Tricyclic antidepressants and SNRIs, Mirtazapine & MAOIs'). Some people found that despite feeling positive benefits for a time, it’s important to have a regular review with the GP, as he or she may be able to change the dose or prescribe something different (see also ‘Reviewing antidepressant use’, ‘Stopping taking antidepressants’ and ‘Changing antidepressants’). 
People we spoke to were often concerned about side effects. Side effects may occur with all of the different types of antidepressant medicines but not everyone will experience them. In our interviews people described a range of different side effects but the intensity or impact varied widely between different individuals and the degree of importance they placed on them varied. As well as the psychological effects of distance, numbness or a sense of detachment mentioned earlier, people described a range of different physical side effects including; sweating, sickness , nausea, dry mouth, a metallic taste , sedative effects, insomnia, weight gain, weight loss, loss of appetite, vivid dreams, trembling, yawning, and sexual dysfunction (see also ‘Coping with antidepressant side effects’). 
 

Last reviewed June 2016.
​Last updated June 2016.
 

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