Lexapro and Insomnia: What You Need to Know

Escitalopram, sold under the brand name Lexapro®, is a common antidepressant that’s used to treat major depression and certain anxiety disorders.

First approved for use by the FDA in 2002, Lexapro is a popular antidepressant. It’s used by millions of people of different ages and backgrounds to make dealing with depression and anxiety an easier experience. 

Although some antidepressants are associated with sleep difficulties, the data on Lexapro and insomnia is mixed. While some Lexapro users report insomnia, there’s also research showing that Lexapro may actually make it easier to fall asleep.

Below, we’ve explained what Lexapro is and how it works. We’ve also looked at the major links between Lexapro and poor sleep quality, as well as what time of day to take Lexapro and the best time to take Lexapro for anxiety.

Finally, we’ve provided several tips to help make falling and staying asleep easier if you’re prescribed an antidepressant.  

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What Is Lexapro?

Lexapro is an antidepressant that contains the ingredient escitalopram. It belongs to a class of medications called selective serotonin reuptake inhibitors, or SSRIs. 

SSRIs like Lexapro work by changing the levels of the neurotransmitter serotonin in your brain and body.

Serotonin, alongside other neurotransmitters, plays a key role in regulating the way your brain behaves, affecting everything from your mood to your ability to sleep properly.

As an antidepressant, Lexapro is very effective. A large-scale scientific review from 2006 found that not only is it effective at treating major depressive disorder, but also that it’s more effective than many other antidepressants.

Your healthcare provider may prescribe Lexapro if you’re affected by depression, or if you have an anxiety disorder such as generalized anxiety disorder (GAD).

Lexapro and Insomnia

Insomnia is one of the  potential side effects of many antidepressants, including Lexapro. For example, it’s listed as one of the most common adverse reactions experienced by people prescribed Lexapro in FDA documentation. 

According to data from the FDA, more than five percent of people who use Lexapro experience insomnia.

This means that if you have trouble falling asleep or staying asleep after you start to use Lexapro, you’re definitely not alone. 

On the other hand, there’s also some scientific evidence that escitalopram (the active ingredient in Lexapro) may actually make it easier for people to fall asleep.

So, if taking it has recently made you wonder, “Does Lexapro make you tired?” you’re not off base.

For example, a study published in 2012 noted that menopausal women experienced improved sleep quality after using escitalopram. 

Overall, the data is mixed, with insomnia reported as a common side effect of Lexapro, while some research suggests that Lexapro may actually improve sleep.  

It’s important to understand that insomnia is a very common symptom of both depression and anxiety, the two disorders Lexapro is commonly prescribed to treat.  

Because of this, if you experience insomnia while you use Lexapro, it may not always be due to your medication.

It can often take several weeks for Lexapro to start working, meaning some of your symptoms of depression or anxiety may persist even after you begin treatment. 

How to Deal With Insomnia From Lexapro

Dealing with insomnia can be an extremely frustrating experience. Luckily, there are steps that you can take to make falling and staying asleep easier. We’ve listed many of these techniques below:

• When to take Lexapro may be important. If you find it hard to fall asleep at night, try taking your dose of Lexapro in the morning instead of later in the day. Make sure that you talk to your healthcare provider to verify that it’s safe to take your medication at this time.

• Avoid drinking coffee or other caffeinated beverages late in the day. Caffeine has a long half-life, meaning it can affect your ability to fall asleep even if you consume it hours before you go to bed.

  To avoid making it even more difficult to fall asleep, avoid drinking coffee or other drinks that contain caffeine after midday.

• Stay active. Not only can exercising make it easier for you to fall asleep at night, it may also improve your depression or anxiety symptoms. Research shows that exercise is an effective, all-natural treatment for improving depression and anxiety.

• Don’t drink alcohol. It’s important to avoid drinking alcohol while you’re using Lexapro or other antidepressants. Not only can this cause side effects, but there’s also evidence that drinking can further disrupt your sleeping patterns and worsen insomnia.

• Avoid technology before bed. As tempting as it can be to spend time on Facebook or watching TV late at night, using technological devices shortly before you go to bed may have a negative impact on your ability to sleep.

These devices can trick your body into thinking that it’s still daytime, preventing it from releasing the sleep-promoting hormone melatonin. To avoid this, try switching off your computer, TV and other screens about an hour before you need to sleep. 

If you still experience insomnia from Lexapro after making changes to your lifestyle, it’s best to talk to your healthcare provider. 

It’s also important to talk to your healthcare provider about your history. For instance, if you have a history of bipolar disorder, using Lexapro or other popular antidepressants may impact your sleep schedule.

Depending on the severity of your insomnia and the progression of your depression or anxiety symptoms, your healthcare provider may recommend adjusting your dosage of Lexapro. They may also suggest switching to another type of medication. 

Alternatively, your healthcare provider may prescribe a sleeping medication to help you fall and stay asleep more easily while you use Lexapro.

In Conclusion

Lexapro is a popular antidepressant used to treat depressive disorders, anxiety and other mental health issues. Unfortunately, Lexapro (and other antidepressants like it) may cause you to experience insomnia. You may notice that it takes you longer than it normally should to fall asleep, or that you struggle to fall asleep even if you feel tired.

If you notice insomnia symptoms after using Lexapro, try applying the techniques listed above to make falling and staying asleep easier.

If these aren’t effective and especially if insomnia symptoms begin to affect your quality of life, talk to your healthcare provider to learn more about your options for overcoming insomnia and improving your subjective sleep quality, or getting off Lexapro. 

Learn More About Antidepressants

Escitalopram, the active ingredient in Lexapro, is one of several antidepressants prescribed for depression, anxiety and other mood disorders.

Our guide to SSRIs goes into more detail about how these medications work, their side effects and more. 

best time to take lexapro for anxiety – en

• 1 Best time to take lexapro for anxiety
  • 1. 1 When is the best time to take my Lexapro? – GoodRx
  • 1.2 Escitalopram (Oral Route) Systemic Use – Mayo Clinic
  • 1.3 When is the best time to take Lexapro? – Drugs.com
  • 1.4 Use Lexapro in Tamil (Lexapro) side effects precautions
  • 1.5 What is the best time to take Lexapro to avoid insomnia?
  • 1.6 Lexapro Side Effects Dosage Uses & More – Healthline
  • 1.7 Is morning or night the best time to take antidepressants?
  • 1.8 When is the best time to take Lexapro for anxiety?
  • 1.9 9 Things to Know When Starting Anxiety Medication – GoodRx
  • 1.10 How and when to take escitalopram – NHS
  • 1.11 Lexapro For Anxiety What You Need To Know – HealthMatch

When is the best time to take my Lexapro? – GoodRx

Lexapro (escitalopram) is an FDA-approved once-daily medication for the treatment of depression and anxiety. In general, you can take Lexapro at any time of the day, with or without food. Be aware of some common side effects and drug interactions with Lexapro.

Escitalopram (Oral Route) Systemic Use – Mayo Clinic

Adults and children 7 years of age and older for generalized anxiety disorder – Start with 10 milligrams (mg) taken once a day in the morning or evening. Your doctor may adjust your dose as needed. However, the dosage is usually no more than 20 mg per day. Elderly – Take 10 mg once a day in the morning or evening.

When is the best time to take Lexapro? – Drugs.com

Drugs.com The Official Answer to Lexapro is usually taken once a day, and you can take it either in the morning or at night. If you find that Lexapro keeps you awake – take it in the morning If Lexapro makes you feel drowsy – take it at night If you have night sweats from Lexapro – take it in the morning.

Use Lexapro in Tamil (Lexapro) side effects precautions

Escitalopram The generic form of Lexapro is primarily used to treat depression and generalized anxiety disorder (GAD). 3 It was initially used only to treat depression, but research has shown it to be effective in treating mood disorders 4 and anxiety disorders. 5

What is the best time to take Lexapro to avoid insomnia?

Summary of Frequently Asked Questions There’s no better time to take it. However, someone who experiences insomnia may want to schedule Lexapro in the morning. Lexapro brand name…

Lexapro Side Effects Dosage Uses & More – Healthline

If you have anxiety or depression, your doctor may prescribe Lexapro for you. It is a drug used to treat generalized anxiety disorder (GAD) in adults for the following conditions:

Is morning or night the best time to take antidepressants?

For example, if your doctor has prescribed you Prozac (fluoxetine), some of the more common side effects include insomnia, agitation, nausea, and vomiting. 1 If you have insomnia, take the medicine in the morning. It is better to take it at night if there is nausea.

When is the best time to take Lexapro for anxiety?

They can give you detailed information and guide you on how to use Lexapro without side effects and advise you when to take it to avoid them. The chart below will tell you the side effects of antidepressants and the best time to take each one. sleep bed time

9 Things to Know When Starting Anxiety Medication – GoodRx

Antidepressants Antidepressants are often used to treat depression. But they can also help with symptoms of anxiety. In most cases they are actually the first-choice anxiety treatment option.

How and when to take escitalopram – NHS

You can take escitalopram at any time, as long as you stick to it at the same time every day. If you have trouble sleeping, it is best to take it in the morning. How long does it take? Once you feel better, you will take escitalopram for several more months to prevent symptoms from returning.

Lexapro For Anxiety What You Need To Know – HealthMatch

If you struggle with anxiety, Lexapro may be prescribed to control your symptoms. Read on to find out how long Lexapro can work and what risks and side effects you should be aware of, and how Lexapro can help. Have you considered clinical trials for anxiety?

We asked young people what it’s like to date while suffering from anxiety and depression

Dating while suffering from a mental illness can be really, really bad. There are a lot of negative stereotypes, and they often ruin otherwise rosy prospects.

Guy A. Boysen, Professor of Psychology at Mackendry University, recently reviewed two studies that unfortunately confirm these stereotypes. In the first, participants rated the prospects of people with mental disorders like depression and schizophrenia in short- and long-term relationships as below average. In the second study, participants rated people’s physical attractiveness based solely on personalized ads that mentioned their disorder. People with mental illness were again widely perceived as having below-average prospects in terms of building long-term relationships.

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We talked to a few single young people about what it’s like to date while suffering from a mental disorder and about the challenges they still face.

Matt, 23, Manhattan, New York

“I’ve always had generalized anxiety and hypochondria. In high school, I went to the doctor a million times and said, “I have a brain tumor!” At university, I started having panic attacks. After uni, I thought, “Okay, I need medication.” So I now take Lexapro and Ativan as needed.”

Could you give me an example of a situation in which you felt you were being judged?
I went on a date with a random Tinder partner or something, and we went out for lunch. Around this time, I usually take Lexapro, and when I took the medicine, he asked what it was. I said, “Oh, it’s just a Lexapro,” and I immediately noticed that it sort of closed when I said that. It was obvious that he knew absolutely nothing about mental health. We never saw each other again, but I still didn’t want to go on a date with this man again.

How has your personal life developed since then?

I’ve noticed a very big change in terms of who I’m willing to confide in or even date. It seems to me that even if I am slightly attracted to a person who does not really understand mental health problems or does not understand what drugs are, then he is a dead number: we simply will not succeed. Also, my lexapro sometimes affects my libido. So I try to take Lexapro at night after my current partner and I have had sex. This is a difficult matter – he understands everything, but he seems unable to put himself in my place, because he did not take drugs that affect sexual desire.

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Emily, 23, San Francisco, CA

“I was diagnosed with Generalized Anxiety and Depression only about six months ago. I take Prozac, which is an antidepressant and an anti-anxiety drug. I also take klonopin – it helps me with panic disorder.

How has this affected your personal life?
I dated a man named Michael* for about a year. I had not taken any medication yet, so my anxiety showed itself in all its glory. If he didn’t want to go to the concert I was expecting, I felt like he didn’t like me or wasn’t interested in me, and he didn’t understand where that came from. Besides, when I’m anxious, I pick my nails. When I did it next to Michael, he just said: “Stop it!” – and beat me on the hands. He could not understand that I had no power over this; my brain does it in a way that I don’t even realize. In January he broke up with me. Said I was too dependent on him; I got so depressed that I ended up going to the doctor.

How does your personal life look like now?

I recently started dating a man named Charlie*. While he was doing well for the most part, I still think about things like drinking when I’m on Klonopin so I don’t have to knock myself out of my wits anymore. He also caused me anxiety attacks, so I realized that I needed to break up with him. I need to be alone and sort out my affairs on my own before dating.

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Nicholas, 29, Brooklyn, NY

“My mother had schizophrenia. She was constantly in and out of mental hospitals; she had breakdowns, she tried to commit suicide, she was treated with electric shock. As I started to grow up, I realized that I myself had some problems. I am currently battling depression and anxiety.”

When did you feel like someone didn’t understand your situation?
I was going home to my ex after work, and that’s when sometimes I get anxious and it becomes difficult to be on the same wavelength with everyone. There was also a group of friends there, but I did not expect this. One person talked about what a cool mom he had. He didn’t stop talking, listing examples, and this particular topic really hurts me, given the kind of PTSD I have.

I tried to calmly explain that this is why I don’t participate in communication, but I really don’t want to blame this person, because he may not understand this. He began to cry and hysteria, and then said that I came out of nowhere, ruined the evening and pulled the blanket over myself. It was hard to explain that I was not in control, and at the same time I felt guilty and reproached myself. I didn’t want to be the center of attention; I don’t want to be bad in social interactions.

Alessandra, 24, Atlanta, GA

“I was diagnosed with severe depression and anxiety six years ago during my freshman year at university. I began to feel a strong apathy and cried for no reason. I realized that something was wrong and took a sick leave from the university.”

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How did this affect your relationship?

Well, when I was 20, I had a boyfriend for the first time. I was then finishing my second year, and I was sitting in his car, and I kept antidepressants in such a small bag in my backpack. I kind of drank two different drugs, and there was also a little advil and midol. They fell to the floor, and he completely went off the rails. First of all, he asked if I was a drug dealer, and I was surprised: why? I have five pills in this purse. I decided to open up to him because, well, I lost my virginity to him and I thought I could trust him. After that, he became very strange. He thought I would cut my wrists no matter what he did or said. I didn’t even get upset, but he still felt very uncomfortable next to me. We broke up the same week—for different reasons—but the catalyst was definitely when he found out about my depression. Our relationship lasted three weeks.

Stephenie, age 24, Queens, NY

“I have borderline personality disorder (BPD), obsessive compulsive disorder (OCD) and panic disorder. My BPD is the root cause of my relationship failure; it is the worst. People understand what OCD is – some even consider it a highlight – but BPD? Nobody understands. Everything just seems like the end of the world to me, and I just feel everything much more subtle. ”

When did this affect any of your relationships?
For some reason, the best friend of my first love felt like I was threatening her. At my girlfriend’s birthday party, this friend tried to throw away my stuff—including my laptop—and I grabbed her wrist to stop her. My girlfriend came in and immediately called me cruel without even asking what was going on. I started to panic and started crying, and my girlfriend started listing textbook symptoms of BPD. She called me a tyrant, a manipulator and a lunatic. She did not understand the complexities of my mental disorder. Then she kicked me out without anything – not even a jacket and shoes, and it was winter. I kept knocking on the door, because I needed at least a phone and things to get home, and her mom called the police. They didn’t know what it was, but at least they gave me a quarter to call my best friend for a ride.

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What happened after this ?

Her mother gave me my things a few days later, and I was also fired from my job – we were employees. They told their side of the story, and our boss saw me as a threat. Her friend started gesturing like she was cutting her neck and wrist and laughing, implying that I should just kill myself. When another employee told her to stop (smiling), the friend said that I would kill myself anyway because I was “nutty” and had nothing to live for.

My ex didn’t talk to me after that for two months, and I had to think it over again for the rest of my life. I was dumped by the girl I loved because of something I didn’t do, and I was also attacked, judged, and mistreated. I hated myself and really thought about suicide because I had been dumped in every relationship before because I was clingy and crazy, so I blamed myself. I went through therapy and it took me a very long time to realize that I am not what she said. After that, it took me another three years to even start dating again.

Ula, 28, Brooklyn, NY

“I have depression and severe anxiety, panic attacks, stuff like that. I also have Asperger’s Syndrome; I am on the autism spectrum. I’m on medication now, but I still experience anxiety attacks. I just have to deal with it; it’s a daily struggle. I am also demisexual, meaning I only feel desire for people with whom I have an emotional connection.”

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How did your personal life develop?
When I was 23, I met my ex. Before that, I kind of thought that I would never date anyone. I thought that it was just not for me and that no one would ever understand me. I don’t like sex, I don’t like it, I don’t even like the thought of it, that’s all. But he said that was fine with him; He likes me the way I am. I fell in love very hard and fast. After about two and a half years together, everything fell apart, and he broke up with me. Later I realized that he was prone to emotional abuse.

Was the emotional abuse related to your mental health problems?

Yes, I would say yes. Even when we broke up, he would say things like, “I can’t deal with your depression, I’m not your therapist.” And also with my disability and my sexuality. Even before I got my diagnosis, he was like, “You’re such an aspie, you’re such a cutie. ” Kind of infantilized me and looked at it from a very ableist point of view. Despite the fact that there are people around me who love me and are interested in me, this feeling comes back again and again, because such is depression – a feeling of abandonment and despair. I want it to be visible. I don’t want to hide it.

Alex, 21, Manhattan, NY

“I have a history of depression and anxiety. I went to psychiatrists, but never decided to start taking medication. I, in my opinion, can manage it very well with coping mechanisms, wellness strategies and the like.”

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Could you tell me about your negative experience with one of your partners?
There was an evening a couple of years ago when anxiety and depression hit me hard. My usual reaction is to shut down, dig in my own head and not react to other people at all. My partner stepped back and gave me space, and I needed the opposite. He had good intentions, but I think he handled it the way he did because of the thought that when people close, there are need to leave alone. This greatly worsened the situation; I tried to show him that I really need to be taken care of, but he didn’t get it. There just wasn’t a direct line of communication.

How has your experience changed the way you view dating?

People seem to think that those with mental health problems are incurable and only they can fix themselves. I understand where this comes from in people, because of the division of emotional labor and things like that. But I realized that in the case of intimate relationships, you need to work with each other to find out the needs, desires and problems of each other. We need to create a system of accountability. I think the most important thing here is to build better relationships through radical honesty and transparency. And here you need not just to show empathy – you also need to be incredibly sympathetic and sensitive.

Ying-Ying, 22, Queens, NY

“I’ve been struggling with depression for a very long time, since I was 15 years old. I couldn’t deal with it because I didn’t know how. I couldn’t understand what the hell was happening to me and my body sometimes, so I started going to a counselor at school.”

How did your feelings affect your approach to dating?
I usually feel such a mess in my head that I convince myself that I cannot open up to people, because there is definitely a negative stereotype around this. There is also the fear that people will not be able to cope with the problems that you are working on.

What was your last relationship like?
The last guy I dated was quite depressed and projected his fears onto me. I realized that I had done this before too. I think it’s actually very common. In my opinion, everyone should go to a psychotherapist and talk about these fears – then we may all stop running from each other. He clearly internalized the negative stereotypes around depression, just as I sometimes do.

What should change ?
We need to make this dialogue more popular. I don’t think we’ll ever be able to take care of relationships if we keep reproducing these negative stereotypes around mental disorders; the relationship ends up breaking down. It’s just not right. I really want to sort this out, all these dating issues. It sucks – I feel lonely as hell.

*names have been changed

how to take drugs, effect, can you drink without a prescription and with alcohol

Medicine and health

Ekaterina Kushnir

treats anxiety disorder

I have generalized anxiety disorder.

For a long time I coped without pills and other help, but one day I got tired of constant anxiety and began to interfere with my normal life. As a result, I turned to a private psychiatrist.

The doctor prescribed an antidepressant from the SSRI group – these are selective serotonin reuptake inhibitors. Such drugs are the first thing prescribed in the treatment of depression and a number of other conditions, including my illness.

The doctor immediately warned me about some peculiarities associated with taking the drug. Some of them I then felt on myself. I think everyone who plans to be treated with antidepressants should know about them.

At the same time, it should be taken into account that most of the negative effects of therapy are temporary and not dangerous, and if they do not go away, one medicine can be replaced with another. Antidepressants help many people with mental disorders and other illnesses get rid of their symptoms and return to a full life, so you definitely should not be afraid of them. The main thing is to take such drugs when they are really needed: as prescribed by a competent doctor and under his control.

See a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don’t write prescriptions, we make recommendations. Relying on our point of view or not is up to you.

Fact No. 1

Antidepressants may make symptoms worse at first

Antidepressants can increase anxiety in anxiety disorders, as well as cause irritability and agitation – the so-called causeless motor agitation, the inability to sit still. It’s not dangerous, but rather unpleasant. This condition is sometimes referred to as initial anxiety, that is, the anxiety of starting therapy. Up to 65% of people face it.

Antidepressant-induced anxiety syndrome – a systematic review in the British Journal of Psychiatry

There is also evidence that some classes of antidepressants, including SSRIs, may increase suicidal ideation in depression in young people aged 18 to 24 years. These data are not very reliable, and in older people, the risk of suicide no longer increases and even decreases.

Without treatment, depression is more likely to lead to suicidal thoughts, and in case of anxiety, you just need to prepare for such an effect, then it will be easier to survive the attacks.

The doctor told me that in the first two or three weeks there may be an increase in anxiety, but I did not take it too seriously.

Everything was fine for the first week. After about seven days, I became nervous and irritable. And then I woke up at night and after a while I felt an incomprehensible fear. My heartbeat increased, my head was spinning, my throat was constricted. Because of this, I felt a real panic – I spent the rest of the night fighting terrible thoughts, in the morning I got up completely broken.

8 myths about antidepressants

I never had such panic attacks before taking medication — my anxiety was background, general. I got scared and wrote to the doctor, who reassured me and said that it was not dangerous and would pass soon.

After that, I was already waiting for these panic attacks, immediately tried to relax, calm down, remember that this was just a temporary effect of drugs. And they ended faster, and then they completely disappeared.

My letter to a psychiatrist. I was scared: I expected an increase in background anxiety, but not panic attacks. I even thought about giving up the medicine

Fact No. 2

The effect of antidepressant treatment will not be immediate

Increase the dose of antidepressants gradually to reduce side effects. They usually start with the minimum, and then bring it up to the working one. For example, for SSRIs with the active ingredient “sertraline”, the working dose is from 100 mg per day. I started taking such a drug with 25 mg, and then gradually, in several steps, under the supervision of a doctor, raised the dose to 100 mg.

SSRI dosage – NHS

What doses of antidepressants will be optimal – an article in The Lancet

The process of reaching a working dose can take from two weeks to a month or more. It depends on the drug and its tolerance. I turned out to be sensitive to the medicine, it was hard for me to survive every increase in dosage: anxiety increased again, there were other side effects that then stopped. However, this is not the case for everyone, sometimes the process goes faster.

The full therapeutic effect, that is, the disappearance or a strong improvement in the symptoms of the disease, occurs some time after reaching the working dosage. As a rule, this is a week or two, although some positive changes may be earlier. For some people, this process stretches for a longer period: 6-12 weeks. Minimum initial doses of drugs usually do not work.

It is better to prepare for the fact that the symptoms of the disease will not disappear in the first weeks of treatment. And remember – this does not always mean that the drug needs to be changed, sometimes you just need to wait or further increase the dosage under the supervision of a doctor.

Fact No. 3

Antidepressants are usually taken in combination with other drugs

Another way to mitigate the side effects of antidepressants is to prescribe an additional drug along with them: for example, from the group of tranquilizers. Such drugs may have their own side effects, they should not be taken for a long time. Unlike antidepressants, some of them can be addictive. They are usually appointed for a month, but this period may be shorter or longer.

Antidepressants together with benzodiazepines work better for depression – BMJ magazine

My doctor prescribed a rather mild drug for me. However, he did not suit me. At first, it caused increased drowsiness: during the period of increased anxiety, it went away for a while, but then returned – even with half a pill I turned off and could sleep all day. And if I drank at night, I woke up with difficulty in the morning. The psychiatrist prescribed another medicine, but I could not buy it: the drug was not available in any pharmacy nearby.

As a result, I simply endured all the side effects of therapy – they were unpleasant, but tolerable. When discussing with the doctor, she called this option acceptable if the side effects of the second medicine only worsen the situation.

My prescriptions for drugs. I never used one, because there was no such medicine in pharmacies

Fact No. 4

Side effects are not always, but they are

Modern antidepressants, including SSRIs, are mild and have almost no side effects. Older drugs – tricyclic antidepressants and monoamine oxidase inhibitors – cause more side effects. Doctors usually use them when milder first-line drugs don’t work or when they can’t be prescribed.

Side effects of antidepressants – NHS

Side effects of different antidepressants – UpToDate

Side effects of antidepressants and their impact on the outcome of treatment of major depressive disorder – Nature

Selective reuptake inhibitors with erotonin – UpToDate

How to deal with side effects effects of antidepressants – advice from the staff of the Mayo Clinic

The choice of an SSRI drug does not guarantee the absence of side effects – many people tolerate treatment easily, but sometimes a change of drug may be necessary.

The first couple of weeks of taking there is a risk that the state of health will be so-so – it’s worth thinking about. It may be worth scheduling the start of therapy on vacation.

I work remotely, and it was easier for me: the first pill was taken on Saturday, I slept through the weekend. Then she continued to work, but refused any additional loads: housework, part-time jobs, training and everything else.

It was hard work: I wanted to sleep, then I began to worry and get distracted. I also had diarrhea, nausea, headaches, tremors, i.e. hand trembling, hot flashes, sweating, palpitations. At night, panic attacks began, in the morning I had difficulty getting up because I was in pain and dizzy.

There are mixed data on how common the side effects of antidepressants are. If we summarize them, then the numbers look something like this:

• nausea – about 25% feel it;
• diarrhea – it happens in 15% of people, and 5%, on the contrary, will have constipation;
• sweating and a feeling of heat occur in about 20% of people;
• sexual dysfunction, decreased libido may occur in 80% of cases;
• insomnia – in 11% of cases;
• headache and dizziness – in about 10-11% of cases;
• weight gain – not all drugs give this effect. Some, on the contrary, can reduce weight. On my medicine, I lost 2 kilograms in the first month, despite the fact that I quit training due to poor health. True, then they returned back.

It can be seen that most side effects occur in less than half of the cases. In addition, in most cases they pass in the first weeks and are not dangerous.

Side effects not listed above are very rare. I was “lucky”, and I faced one such – a decrease in visual acuity. Once in the morning I noticed that I see worse without glasses. A little later, I realized that something was wrong with the glasses.

I wrote to the doctor, she replied that this happens, as a rule, is not dangerous and passes, but it is better to visit an ophthalmologist. I went to the ophthalmologist, everything was fine with my eyes, there was nothing terrible, but my vision really worsened – it was not a subjective feeling. On the right eye, it was -0.5 diopters, it became -0.75, and on the left eye it was -1. 5, and it became -3.5.

I was offered to try changing the drug, but I decided to wait. Vision was then restored. I have not yet gone to the doctor to have it measured, but according to subjective feelings, it is at the same level as before: I am comfortable again in my glasses.

Side effects should not be tolerated – if something greatly worries, scares or interferes with life, it is better to tell the doctor right away. The psychiatrist will be able to determine whether the side effect of the drug is dangerous and whether it is worth continuing to take it. There are several antidepressants of the SSRI group, in addition, there are groups of drugs with a slightly different mechanism of action. As a rule, doctors manage to find a medicine that gives a good effect without side effects.

If there is no danger, the doctor can adjust the dose or increase it more gradually – this often helps to cope with unpleasant effects.

I wrote to the doctor again when my visual acuity decreased

Fact No. 5

Antidepressants need to be taken long term

Antidepressants are not drugs that you can stop drinking as soon as you get better. They are taken for a long time: usually from several months, less often several years.

Anxiety Therapy – UpToDate

For example, for generalized anxiety disorder, the duration of treatment is at least a year. Moreover, the date is not counted from the very beginning, but from the moment when a lasting effect appeared from the pills. In fact, they will have to be drunk for about 1.5 years – it depends on how long it takes to reach the working dosage of the medicine.

The cost of a package of the most famous antidepressant “Zoloft” is about 700 R, enough for about a month. That is, a course of therapy will cost about 10,000 R – maybe more or less, depending on which drug is selected.

Psychotherapy review – UpToDate

Another drug of the same group already costs more than 2000 R per pack. Source: rigla.ru

The cost of an appointment with a good psychiatrist in Moscow is 3000-5000 R. At first, you will need to visit him about once every 1-1.5 months, then less often.

You can apply to the psycho-neurological dispensary at the place of residence under compulsory medical insurance – it’s free. At the same time, they will not put you on psychiatric registration: it was canceled in 1993. People with disorders that do not threaten their lives or those around them are on consultative and diagnostic care. If you stop going to the doctor, he will not find out what happened: a person seeks help at will.

Psychotherapy, usually cognitive-behavioral, is also commonly prescribed to enhance and sustain the effects of antidepressants. In many cases, it improves the effectiveness of drugs, including depression and generalized anxiety disorder. An appointment with a psychotherapist in Moscow costs an average of 5000 R. For treatment, you will need about 10 sessions or more.

How psychotherapy works

Fact No. 6

Antidepressants should not be stopped abruptly

Antidepressants do not develop dependence. However, if you abruptly stop drinking them, there will be a withdrawal syndrome. This is felt as electric current discharges while moving or turning the head, headaches, dizziness, insomnia. Many people experience symptoms similar to the flu or an intestinal virus: low fever, diarrhea, general malaise, chills. Often there is anxiety, there are intrusive images.

Withdrawal symptoms after taking serotonin reuptake inhibitors – Journal of Clinical Psychiatry

How difficult it is to stop taking antidepressants – American Psychological Association

Stopping antidepressants in adults – UpToDate

for some reason they changed their minds about taking the pills or the term has expired treatment, they should be canceled only under the supervision of a doctor.

Antidepressant withdrawal occurs as gradually as the start of treatment. The dosage is slowly reduced, usually at this time again a cover-up drug is prescribed to alleviate side effects. As a rule, this is the same medicine that was at the beginning of the intake.

Withdrawal is usually harmless and resolves within the first weeks of stopping the drug. Sometimes even within a few days – it still depends on which medicine was prescribed. If severely disturbing symptoms appear during the withdrawal period, you should consult a doctor.

Fact No. 7

If you need to change the drug, everything will start over

It is far from always possible to immediately find the right antidepressant – sometimes the side effects do not go away and you need to take a new one.

Changing antidepressants in adults – UpToDate

Serotonin syndrome – MSD

Most often, it is started again with a small dosage, this delays the process of obtaining the effect of treatment. The new drug may also have side effects – the same or different. We will have to wait again until they pass.

You won’t be able to change the drug on your own, since all antidepressants are sold only by prescription – and that’s good. Switching from one drug to another can be dangerous if you do not know the characteristics of different groups of drugs.

For example, taking SSRIs is possible only some time after the withdrawal of antidepressants from the group of monoamine oxidase inhibitors – due to the risk of developing serotonin syndrome. This is a potentially fatal condition, accompanied by a change in mental state, high fever, increased muscle tone and other symptoms.

If the drug is changed correctly, there will be no dangerous negative effects, so consultation with a doctor is required.

How to choose a psychotherapist

Fact No. 8

Among antidepressants there are original drugs and generics

Preparations may be original or generic. Originals are medicines first released by some pharmaceutical company that have passed all clinical trials and checks. Generics are drugs with the same active ingredient from another pharmaceutical company, that is, copied from the original drug.

Theoretically, the action of generics should not differ from the action of original drugs. However, this is possible, since generics may contain other additional substances or the manufacturer may use other raw materials.

Due to my anxiety, I did not read anything in detail about specific drugs before I bought my first antidepressant in a pharmacy so as not to be scared and not think about taking it. I also didn’t think to ask the doctor about this question.

Psychoneurological complications after covid: memory problems and depression

As a result, I first bought a generic because it was in stock. Then it turned out that, after all, according to the experience of my psychiatrist, the original drug often gives fewer side effects and is better tolerated. As a result, I changed the generic to the original drug – and, indeed, the side effects softened.

In my subjective opinion, which is supported by some data, in the case of antidepressants and other psychotropic drugs, you should always choose the original medicine. Moreover, the cost of originals and generics is not always very different.

Originals and generics of some SSRIs

Sertraline

Original

Zoloft

Original price

About 700 R, tablets 100 mg

90 002 Generics

Serenata, Serlift

Cost of generics

500-600 R , tablets 100 mg

Escitalopram

Original

Cipralex

Original cost

3000 R, tablets 10 mg

Generics

Selektra, Elycea

Cost of generics

500-1300 R, tablets 10 mg

Fluoxetine

Original

Prozac

Original cost

About 350 R, tablets 20 mg

Generics

Profluzak, Fluoxetine

Cost of generics

100-200 R, tablets 20 mg

My pills: I bought several packs of Serenata at once, so one remained unclaimed ovannoy

Fact No. 9

Do not take alcohol along with antidepressants

Drinking alcohol while taking antidepressants may exacerbate unpleasant side effects. Also, alcohol is a depressant, that is, it has the opposite effect, and its intake can adversely affect the results of treatment.

Why you shouldn’t mix antidepressants and alcohol – Mayo Clinic

Alcohol is strictly forbidden to drink with some groups of antidepressants, for example, tricyclic antidepressants and monoamine oxidase inhibitors: combination with the latter, for example, can lead to an uncontrolled increase in pressure. MAO inhibitors in general require a special diet – it is unlikely that a doctor will prescribe such drugs as the first antidepressants, but if necessary, he will issue a list of what is allowed and prohibited.

With other antidepressants, moderate use may not be dangerous and may even pass without consequences, but doctors still recommend abstaining so as not to increase side effects and improve treatment outcome.

The main thing is not to temporarily stop taking the drug in order to drink. This can lead to the development of a withdrawal syndrome.

How I Treated Generalized Anxiety Disorder under CHI

Fact No. 10

Antidepressants are incompatible with certain drugs and have contraindications

It is important to tell your doctor what medications you are taking and what chronic illnesses you have. For example, SSRIs may not be suitable for epilepsy and bleeding disorders, and tricyclic antidepressants are usually not prescribed for those who have recently had a heart attack, suffer from glaucoma, or porphyria.

Antidepressant Warnings – NHS

Drug Compatibility Test – Drugs.com

It is also important to be careful if you are about to take any over-the-counter medicine. For example, ibuprofen, which people often take on their own to relieve pain and reduce fever. It should not be taken with SSRIs as it increases the risk of gastrointestinal side effects.