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Antidepressants may cause mild and often temporary side effects in some people, but usually they are not long-term. However, any unusual reactions or side effects that interfere with normal functioning or are persistent or troublesome should be reported to a doctor immediately.

The most common side effects associated with SSRIs and SNRIs include:

• Headache-usually temporary and will subside.
• Nausea-temporary and usually short-lived.
• Insomnia and nervousness (trouble falling asleep or waking often during the night)-may occur during the first few weeks but often subside over time or if the dose is reduced.
• Agitation (e.g., feeling jittery).
• Sexual problems-women can experience sexual problems including reduced sex drive and problems having and enjoying sex.

Tricyclic antidepressants also can cause side effects including:

• Dry mouth-it is helpful to drink plenty of water, chew gum, and clean teeth daily.
• Constipation-it is helpful to eat more bran cereals, prunes, fruits, and vegetables.
• Bladder problems-emptying the bladder may be difficult, and the urine stream may not be as strong as usual.
• Sexual problems-sexual functioning may change, and side effects are similar to those from SSRIs and SNRIs.
• Blurred vision-often passes soon and usually will not require a new corrective lenses prescription.
• Drowsiness during the day-usually passes soon, but driving or operating heavy machinery should be avoided while drowsiness occurs. These more sedating antidepressants are generally taken at bedtime to help sleep and minimize daytime drowsiness.

At one time, doctors assumed that pregnancy was accompanied by a natural feeling of well being, and that depression during pregnancy was rare, or never occurred at all. However, recent studies have shown that women can have depression while pregnant, especially if they have a prior history of the illness. In fact, a majority of women with a history of depression will likely relapse during pregnancy if they stop taking their antidepressant medication either prior to conception or early in the pregnancy, putting both mother and baby at risk.

However, antidepressant medications do pass across the placental barrier, potentially exposing the developing fetus to the medication. Some research suggests the use of SSRIs during pregnancy is associated with miscarriage and/or birth defects, but other studies do not support this.  Some studies have indicated that fetuses exposed to SSRIs during the third trimester may be born with “withdrawal” symptoms such as breathing problems, jitteriness, irritability, difficulty feeding, or hypoglycemia.

In 2004, the U.S. Food and Drug Administration (FDA) issued a warning against the use of SSRIs in the late third trimester, suggesting that clinicians gradually taper expectant mothers off SSRIs in the third trimester to avoid any ill effects on the baby.

Although some studies suggest that exposure to SSRIs in pregnancy may have adverse effects on the infant, generally they are mild and short-lived, and no deaths have been reported. On the flip side, women who stop taking their antidepressant medication during pregnancy increase their risk for developing depression again and may put both themselves and their infant at risk.

In light of these mixed results, women and their doctors need to consider the potential risks and benefits to both mother and fetus of taking an antidepressant during pregnancy, and make decisions based on individual needs and circumstances.

In some cases, a woman and her doctor may decide to taper her antidepressant dose during the last month of pregnancy to minimize the newborn’s withdrawal symptoms, and after delivery, return to a full dose during the vulnerable postpartum period.