Medication can be a double edged sword. It’s ironic when a pill that’s supposed to make you feel better actually makes you feel worse, maybe in ways unrelated to why you were taking the medication in the first place. Psych meds, especially certain classes of antidepressants, which are used for treatment of both anxiety and depression, are notorious for causing undesirable side effects.
Fatigue. Brain zaps. Nausea. Dizziness. Feeling like a zombie. Excessive sweating. You name a side effect, I’ve experienced it.
Side effects even landed in me in the ER a few years ago, when I was starting a new medication that made me feel sick to my stomach and lose my usually ravenous appetite. I was barely eating or drinking anything. Needless to say, my dehydration and malnutrition landed me in an ambulance, ending up in a New York City emergency room where the doctor’s only advice was, “Stop taking that medication.”
It wasn’t that easy, though. I didn’t want to feel like crying every morning and have panic attacks at work everyday anymore. But was the promise of bit more sanity worth feeling so physically ill?
Side Effects Caused by Psych Medications
Psych meds can cause a wide array of side effects, depending on the individual and what kind of medication is being taken. According to Steven Siegel, MD, PhD, chair of the department of psychiatry and the behavioral sciences at the Keck School of Medicine of USC, some of the most common adverse effects of antidepressants are “mild fatigue, mild weight gain, decreased emotional range, and reduction of libido.”
However, there are plenty of less common side effects of antidepressants, like dry mouth and blurry vision. Ironically again, antidepressants used to treat depression and anxiety can cause increased feelings of depression, anxiety, and suicidal thoughts.
Some of the most common side effects of antipsychotics, which are prescribed for schizophrenia and bipolar disorder, are “increased appetite (and resulting weight gain), increased prolactin (women may lactate and men grow breast tissue), somnolence [sleepiness], and restlessness,” according to Siegel.
Anxiolytics, or anti-anxiety medications, such as benzodiazepines (Xanax, Klonopin, and the like) can cause drowsiness, confusion, sedation, and weight gain. These are typically prescribed for people with anxiety disorders.
There really is no medication that comes without the risk of some kind of short- or long-term side effects.
Prevalence of side effects with psych medications
Not everyone will experience side effects from their medications (lucky ducks!) but research has shown that having side effects for at least some duration of treatment is relatively common. One study found that 55% of participants had one or more bothersome side effects after days 75 to 105 of treatment when taking SSRIs — the most commonly prescribed class of antidepressants — which includes Paxil, Zoloft, Prozac, and Lexapro, to name some of the most popular ones.
Another study showed that 54% of participants experienced side effects from their antipsychotic medications. Of those people, 41% said their side effects were very or extremely bothersome.
So, how does one decide if these side effects are worth it?
Weighing the Pros and Cons of Medication
When experiencing side effects, you and your doctor must make a decision on whether dealing with the side effects is worse than dealing with the symptoms of your mental health condition. It almost becomes a game of Would You Rather. Would you rather have an improved mood and more motivation, but experience sexual dysfunction as a side effect, or continue to feel depressed with no motivation but have your “normal” sex life?
“It is important to recognize that there are risks to non-treatment, so that’s the side effect of not treating, so to speak. Then you always have to balance side effects with the beneficial effects of the medicine,” Siegel states. “Disproportionate focus on side effects leads to use of ineffective medications to reduce risk/liability, but also that reduces benefit.”
Essentially, you’ll have to determine how much benefit you’re getting from the medication for the condition you’re taking it for. Are you experiencing relief and reduction of symptoms from the mental health condition that you’re being treated for? If you really are feeling better mentally, can you put up with the side effects you’re experiencing?
If you’ve just recently started a new psych medication, Siegel recommends waiting it out and giving it a chance, at least a for a little bit. “Many [side effects] become reduced, but not absent, after a few weeks,” he says. Usually, this is especially true for side effects involving upset stomach, for example, as your body adjusts to a new medication or a new dosage.
“Medication discontinuation is a choice to accept the symptoms and diseases that were being treated. In general, the disease is far worse than the side effects,” Siegel says. Additionally, he says that it’s very rare for someone to experience more side effects than benefits from a psych medication, if the medication is being prescribed appropriately. However, if it’s been a few weeks and the side effects you’re experiencing are debilitating — more debilitating than the mental health condition you’re dealing with — it’s time to come off the medication and switch it for a new one.
There are certain conditions or situations where it is more realistic to come off of medications and simply rely on lifestyle changes and therapy. Seigel says, “Mild to moderate depression and anxiety may be managed with therapy if the patient is open to change and the therapist is skilled. In those cases, medication side effects may not be obligatory, but only because medication isn’t.”
Again, this is a decision you need to make along with your doctor, not by yourself. But, if you do suffer from mild to moderate depression or anxiety that isn’t severely impairing your ability to function day-to-day, there’s a good chance that your doctor will be on board for safely weaning you off a medication and having therapy be your main treatment. “There’s great evidence that says psychotherapy is more long lasting and effective than medicine,” says Siegel. “It’s just not very fast.”
If you’re experiencing undesirable side effects but still want to stay on medications, you have options. Luckily, there are loads of other medications that you can try, or medications that you can add on to counteract certain side effects. You and your doctor can try different dosages, different classes of medications, or even just taking the current medication at a different time of day. All of these alterations can make a difference in terms of side effects.
The Bottom Line
It can take a lot of trial and error, but it is possible to find a medication that works for relieving your mental health symptoms and doesn’t cause you a whole lot of distress with side effects. Have patience and understand that finding the right medication for you might not happen overnight. When you find the medication that’s the best for you, and you feel both physically and mentally well, it’ll all be worth it.
If your mental health is suffering, consider trying Talkspace online psychiatry — a convenient, inexpensive way to get back on track.