Antidepressant medicines may improve or completely relieve the symptoms of depression. If you are mildly depressed, you may not have to take them, but most people with moderate or severe depression need medicine.

Antidepressant medicines work in different ways. No antidepressant works better than another, but different ones work better or worse for different people. The side effects of antidepressant medicines are different and may lead you to choose one instead of another.

You may have to try different medicines or take more than one to help your symptoms. Most people find a medicine that works within a few tries. Other people take longer to find the right one and may need to take the antidepressant and another type of medicine, such as an antiseizure, mood stabilizer, antipsychotic, or antianxiety medicine.

Together you and your doctor will decide if you need medicine, what things you'll need to think about if you need medicine, and which medicine is right for you.

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Medicine choices

Antidepressant medicines include:

• Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).
• Tricyclic and tetracyclic antidepressants, such as doxepin (Sinequan) and nortriptyline (Aventyl, Pamelor).
• Other antidepressants, such as bupropion (Wellbutrin, Wellbutrin SR), mirtazapine (Remeron), trazodone, and venlafaxine (Effexor, Effexor XR).
• Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan), phenelzine sulfate (Nardil), and selegiline (Emsam).

Side effects and safety

Antidepressant medicines have side effects. You may notice the side effects before you notice that the medicine is helping you. Side effects vary depending on the medicine you take.

People who are taking medicines for other health problems need to know about medicine interactions. Talk with your doctor about the best way to track whether a combination of medicines is harming you. People who are taking a lot of medicines also are more likely to have harmful side effects.

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How long will you need medicines?

If you take antidepressants, you should take them for at least 6 months after you begin to feel better. This can help prevent you from feeling depressed again (relapse). If this isn't the first time you have been depressed, your doctor may want you to take these medicines even longer.

You may start to feel better within 1 to 3 weeks after starting your antidepressant medicine. But it can take as many as 6 to 8 weeks to see a great deal of improvement. If you have questions or concerns about your medicines, or if you don't notice that you feel better by 3 weeks, talk to your doctor.

Some people need to remain on medicine for several months to years. Others will need medicine long-term. This is more likely if you have had several bouts of depression that seriously affected your home life, work life, or both.

Don't quit taking your medicines without talking to your doctor. If you quit suddenly, it can cause your depression to return and it can cause dizziness, anxiety, fatigue, and headache. If you and your doctor decide you can quit using medicine, gradually reduce the dose over several weeks.

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