Starting antidepressants is often accompanied by anxiety. You open the leaflet, see a long list of possible side effects, and start to have doubts.
The first and most important rule to remember: experiencing a side effect does not mean that the medication is not right for you. Most often, it is simply a sign that your body is adapting to the new conditions.
During the first 2–4 weeks of treatment, temporary reactions may occur. Some people experience several symptoms at once, while others experience none. Common symptoms during the adjustment period include:
- Nausea and abdominal discomfort, diarrhea or constipation.
- Headache, dizziness, weakness, and fatigue.
- Drowsiness or, conversely, insomnia.
- Dry mouth, increased sweating, and mild tremor.
- Changes in appetite and a temporary increase in anxiety.
Sexual side effects deserve special mention, including decreased libido and difficulties with arousal or orgasm. Unlike nausea or headache, these symptoms may persist beyond the initial adjustment period. If this is important to you, be sure to tell your doctor — this is a problem that can and should be discussed.
Many of these early reactions become milder as the body gets used to the medication. However, you should consider not only the type of symptom but also its severity, duration, progression, and how it affects your daily life (sleep, eating, work, and safety).
For easier assessment of your condition, you can use the “traffic light” system.
🟢 Green Zone: You Can Monitor
The symptom has appeared, but it is mild, tolerable, and gradually becoming less intense. Your overall condition is stable, and you can continue with your usual activities. The reaction is not becoming stronger from day to day.
What to do: Continue taking the medication as prescribed. Briefly record the intensity of the symptom and discuss it with your doctor at your next scheduled appointment.
🟡 Yellow Zone: Discuss It with Your Doctor
The symptom is significant and difficult to tolerate. The reaction is not improving, persists, returns, or is becoming stronger. It is beginning to interfere with your everyday life: affecting sleep, eating, work, studies, or relationships. This zone also includes new changes such as severe inner restlessness, palpitations, unusual mood changes, or noticeable sexual problems.
What to do: Contact your treating doctor or clinic rather than waiting for your next scheduled appointment (there may not be an immediate threat, but the reaction needs to be assessed). Tell your doctor when the symptom started, how severe it is (on a scale from 0 to 10), and what aspects of your daily life it affects.
🔴 Red Zone: Urgent Help
These are situations that require immediate intervention. Do not wait for a scheduled appointment. Seek urgent medical care or call 112.
Allergic reaction: swelling of the lips, tongue, or throat, difficulty breathing, a rapidly spreading rash, or fainting.
Serotonin syndrome: a combination of high fever, agitation, heavy sweating, rapid heartbeat, diarrhea, and muscle rigidity.
Safety: a sudden worsening of suicidal thoughts or an urge to harm yourself. In this situation, do not stay alone. Tell someone close to you, remove dangerous objects from your immediate environment, and seek emergency medical help.
Sudden changes in behavior (Risk of hypomania/mania): If you or people close to you notice that your mood has become unusually elevated, you have become excessively cheerful, restless, or talkative, or you have a feeling that “nothing can go wrong.” You may feel that you no longer need much sleep (sleeping 2–5 hours and still feeling full of energy), have many grandiose ideas, or, conversely, develop extreme, uncontrollable irritability and anger.
Other warning signs: seizures, loss of consciousness, severe chest pain, or a serious heart rhythm disturbance.
The main rule: Never stop taking your medication or change the dose on your own! Stay in contact with your treating doctor and remember the basic safety rules.