Which antidepressants are meant to give the least side effects?

[bookworm1982]

I know it's different for everyone, but I know that some are worse than others and I wondered if anyone had a bit of info here. Thanks a lot!

Mirtazapine can cause weight gain but is amazing for sleep. Citalopram helps with focus and motivation but can cause nausea and spaced feeling at higher doses. Sertraline, the main side effect for me was lack of focus and motivation. All of them do a similar job imho, more important is getting the right dose.

Thanks for your reply. Can anyone else help too?

I've switched from taking paroxetine to sertraline recently as sertraline is more conception friendly and we're ttc. I never had much side effects with either. I take the mood stabiliser quetiapine too and that has made me gain weight, for sure, but I'm in a better place with my head so it's kind of worth it.

Watching with interest. I've taken citalopram in the past and felt nauseous but I need to start taking something soon.

I’m on Escitalopram, it’s meant to have very few side effects and it seems to be true for me after trying many others.

Escitalopram is meant to have the least side effects.

However it had the worse for me.

Escitalopram. Have been on it for 18 months - barely any side effects (slight headache for first few days) and very effective for me.

It really is different for everyone. The most widely tolerated are probably sertraline and citalopram but I had urine retention on Sertraline and hallucinations on Citalopram. Couldn't handle them at all.

Fluoxetine I threw up for 6 days solid before I gave up.

Paroxetine gave me some really dark thoughts and urges. I was behind a parent with a tantrumming toddler in a queue and was so irritated by it that I was having this daydream where I grabbed the kid by the hair and smashed his face into the counter until he shut up. It was a really strong urge to do it too. It wasn't the first time that week either. Scared the shit out of me and I came off them the same day. I was really worried I'd do something violent to someone. Fluoxetine and Paroxetine are usually the second choice as most people get on with them.

Mirtazepine is the next drug of choice if you can't deal with SSRIs but I gained 4 stone in as many months and I was fat to start with.

Duloxetine I just felt ill on like I had the flu.

Amitriptyline is a much older antidepressant that has so many bad side effects that they hardly ever prescribe it for depression anymore. Its mostly used in very low doses to treat nerve pain, bed wetting and sometimes as a sleep aid. Doctors do a double take when I tell them the dose and ask me if I'm absolutely sure its that one, that's how bad its reputation for side effects is, that it's barely ever even considered as worth a try. I got a few spells of dizziness in the first 2 weeks and a dry mouth that has persisted. And it works. Obviously I stayed on it, I'll live with the dry mouth but had to really push to try it in the first place.

Everyone is so different, its really just trial and error.

Interesting.... I’m on Amitryptiline after so many hideous hideous side effects.

Escitalopram made me suicidal in the start up phase
Paroxetine and Mirtazapine made me gain so much weight
Sertraline made me worse.

@ArseInTheCoOpWindow Do you get a dry mouth with yours? When I wanted to try it, they talked like it was cyanide I was asking for and made me see a psychiatrist to prescribe it but its been fine, that's literally the only bad thing about it.

Yeah, and it makes me overeat. Those are the only issues though.

It’s the gold standard. The one against which all the others are compared.

Can I ask those who take Amitriptyline - does it make you feel tired the next day? I take it to help me sleep and it is really effective but the next day, I've felt drowsy. I took some last night and today I don't feel too bad, so does your body get used to it over time. I also take it quite late as I'm currently going to bed fairly late. Assuming if I took it earlier in the evening, I would feel less drowsy the following day?

@nothingcanhurtmewithmyeyesshut
I was on amitriptylne for years up until I fell pregnant in 2016, my doctor switched me. Iv been on 3 different ones since and nothing has ever helped me or made me feel better as much as them. Unfortunately no doctor will prescribe them again for me no matter how hard I tell them they worked really well!

The trick with Amitryptiline is to take it about 2 or so hours before bed.

And yes the drowsiness definitely wears off, but the sleep doesn’t.

Amitryptiline is THE antidepressant for pregnancy. It’s the one with the most data and therefore the safest.

I overeat anyway so I wouldn't notice...

Yeah I try not to take it much later than 10 otherwise I want to sleep in and I have to be up at 7.30 for work.

Psychiatrists will prescribe it if you've tried enough others but GPS won't prescribe over 50mg. Frustrating because it DOES work.

I think half the problem is that it is absolutely lethal in overdose so no one wants to take responsibility if they prescribe it and the patient kills themselves and they then have to justify why they prescribed that particular AD over the newer, more widely tolerated and significantly less dangerous drugs.

What amount of Amitryptiline do you take? I'm on a low dose for sleep and wondering if a higher does might take the edge of my mood.

Mirtazipine didn't give me many side effects - a bit of a shaky jaw, increased appetite and a feeling of general weakness for about a week until the side effects wore off.

I'm also prescribed venlafaxine, the side effects when I started that were pretty horrendous - panic, fear, heart racing but glad I hung in there because they've made a BIG difference.

@User8497t8675 150mg per night. They won't give you higher than 25mg though for sleep as after that there's actually no benefit. The best dose for sleep is generally 10mg. You need over 50mg to treat depression or anxiety effectively but your GP is unlikely to give it unless you've tried literally everything else. It took me 2 years, all the above drugs and 2 psychiatrists to be given it and I'd had it before for nerve pain. They're really trying to get people off it I think.

I take Valdoxan (agomelatine), a newish AD that acts on melatonin. I can't take any of the common ADs that act mainly on serotonin because they cause a severe tremor. I'm not aware of any side effects from the Valdoxan - I think some studies have suggested fewer side effects too.

@User8497t8675 my GP suggested taking amytriptilene 12 hours before one wants to be awake - so eg at 7.30pm if you want to wake up at 7.30am. His words ‘it may affect your evening instead’

I can report that doing this makes getting up in the mornings much easier. I don’t always do a full 12 hours but I make sure to take it early in the evening rather than just before bedtime

To the original OP: side effects really seem to vary massively person by person. Probably best to try one and keep an eye out for side effects

As PP have said Citalopram is the go to drug for least side effects, but everyone is different. It took me 10 years and about 5 different types before I found Venlafaxine, which I've now been on for 13 years. There will be one out there that suits you, good luck.