Antidepressants

Examples: Fluoxetine (Prozac), Sertraline (Zoloft), Escitalopram, Paroxetine, Fluvoxamine

Block the reuptake of serotonin in synapses, increasing its availability. They are the most prescribed antidepressants because of their good efficacy and more tolerable side-effect profile.

Used for: Depression, generalized anxiety, OCD, social phobia, PTSD, bulimia

Examples: Venlafaxine, Duloxetine (Cymbalta), Desvenlafaxine

Act on two neurotransmitters — serotonin and norepinephrine. They tend to be more effective for chronic pain associated with depression and for physical symptoms.

Used for: Depression, generalized anxiety, neuropathic pain, fibromyalgia

Examples: Amitriptyline, Nortriptyline, Clomipramine, Imipramine

Inhibit the reuptake of serotonin and norepinephrine, but also block other receptors, resulting in more side effects. Highly effective, but less used as first-line today.

Used for: Treatment-resistant depression, chronic pain, migraine, bedwetting

Examples: Phenelzine, Tranylcypromine, Moclobemide

Block the enzyme that breaks down serotonin, dopamine and norepinephrine. Very effective, especially in atypical depression. Require a restricted diet and have many drug interactions.

Used for: Treatment-resistant depression, atypical depression, social phobia

"Antidepressants are addictive"

Antidepressants do not cause dependence in the clinical sense. They can cause discontinuation syndrome if stopped abruptly (dizziness, irritability, "brain zaps") — which is why tapering off is gradual and supervised. That is different from dependence or addiction.

"Antidepressants change your personality"

The goal of an antidepressant is to remove the symptoms that are distorting functioning, not to alter personality. Well-treated patients often describe feeling like "themselves" again — not a different version.

"Taking an antidepressant means weakness"

Depression is an illness with a neurobiological basis. Taking an antidepressant for depression is just as logical as taking a blood-pressure medication for hypertension. The stigma around psychiatric treatment kills — untreated depression is a leading cause of suicide.

"You have to take it forever"

Most people take it for 6-12 months after a first episode and then taper off gradually. Those with recurrent depression may need longer-term use — an individual decision made with a doctor, not a life sentence.

How long does an antidepressant take to work?

The full antidepressant effect typically takes 2-6 weeks. In the first few days, side effects can appear before the benefits do — which often leads people to abandon treatment too early. The general rule is to wait 4-6 weeks before evaluating whether the medication is working, always with medical follow-up.

Can I take an antidepressant and do therapy at the same time?

Yes — and the combination tends to be more effective than either one alone. Medication eases symptoms, creating the conditions for therapy to be more productive. Therapy (especially CBT) teaches skills that help prevent relapse when the medication is eventually tapered off.

Do antidepressants cause weight gain?

Some antidepressants are associated with weight gain, especially paroxetine, mirtazapine and amitriptyline. SSRIs like sertraline and fluoxetine have less impact on weight — and fluoxetine may even cause slight initial weight loss. The effect varies between people. If weight gain becomes a problem, there are alternatives with a more favorable metabolic profile.

Can I stop taking an antidepressant suddenly?

No. Abrupt discontinuation can cause discontinuation syndrome: dizziness, nausea, irritability, insomnia, sensations resembling electric shocks. Tapering off should be gradual — a slow dose reduction over weeks to months, always guided by a doctor.