Antidepressant basics: what to expect and how to choose

Starting an antidepressant can feel confusing. You want to know how fast it works, what side effects to watch for, and how to pick the right type. This page gives clear, practical answers so you can talk with your doctor and feel more in control.

How antidepressants work and the main types

Most antidepressants change brain chemicals that affect mood. The common classes are SSRIs (like sertraline), SNRIs, atypical antidepressants, and older options like tricyclics. SSRIs are often first-line because they tend to be easier to tolerate. SNRIs can help when pain and mood overlap. Atypical drugs target different receptors and may be picked for specific symptoms or side-effect reasons.

Expect slow gains—not overnight fixes. Some people notice sleep and appetite changes within a week, but mood and energy often improve over 4–6 weeks. If there’s no benefit after a full trial (usually 6–8 weeks at an adequate dose), bring that up with your clinician.

Practical tips: side effects, interactions, and switching

Side effects vary by drug. Common early ones are nausea, mild headaches, sleep changes, and low sexual desire. Many of these ease after 2–4 weeks. If sexual side effects or weight gain become a problem, there are alternatives to discuss—some posts on this site cover options and trade-offs.

Watch for interactions. Don’t mix MAOIs with SSRIs. St. John’s wort plus many antidepressants raises the risk of serotonin problems. Combining NSAIDs or blood thinners with SSRIs can increase bleeding risk. Alcohol can worsen mood and make some meds less effective. Always list every prescription, over-the-counter medicine, and supplement for your prescriber.

Stopping suddenly can cause withdrawal-like symptoms (dizziness, flu-like feelings, or mood swings). If you and your doctor decide to stop a drug, taper slowly when possible. If a medication isn’t working or side effects are bad, your clinician may switch drugs, add another med, or try therapy first.

Practical things you can do now: keep a simple mood diary (rate mood, sleep, appetite each day), track side effects, and pick one measurable goal (sleep 7 hours, go for a 20-minute walk three times a week). Bring these notes to appointments—concrete details help your doctor pick the next step.

Want deeper reads? Check our guide on Sertraline and bipolar disorder for special cautions, and read about alternatives to Quetiapine if weight gain or sedation is a concern. If you have questions, talk to a prescriber or pharmacist—mental health meds are personal, and small changes can make a big difference.