This is an unofficial archive of PsychonautWiki as of 2025-08-08T03:33:20Z. Content on this page may be outdated, incomplete, or inaccurate. Please refer to the original page for the most up-to-date information.
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Antidepressants are a class of psychoactive substances that are prescribed to treat psychiatric disorders, most commonly major depressive disorder and some forms of anxiety disorders.
As a result, it may contain incomplete or wrong information. You can help by expanding it.
MAOIs and TCAs were among the first antidepressants developed. They have largely been superseded by newer antidepressants (such as the SSRIs) that have fewer side effects, although these older antidepressants may still suit certain people or be effective when other antidepressants have been ineffective.
Classes
Antidepressants are classified into different types depending on their structure and mechanism. There are at least seven types of antidepressant:
Serotonin antagonist and reuptake inhibitors (SARIs)
Tricyclic antidepressants (TCAs) and tetracyclic antidepressants (TeCAs)
And the miscellaneous antidepressants.
Uses
Antidepressants help to relieve the symptoms of depression such as low mood, irritability, feelings of worthlessness, restlessness, anxiety, and difficulty in sleeping.
In addition to depression, certain antidepressants may also be used to treat a range of other conditions, for example:
Anxiety
Bed-wetting
Bulimia nervosa
Chronic nerve-related pain
Fibromyalgia
Hot flashes
Migraine prevention
Obsessive-compulsive disorder
Panic disorder
Post-Traumatic Stress Disorder (PTSD)
Premenstrual dysphoric disorder
It is important to note that not all antidepressants are used to treat the conditions mentioned above.
Antidepressants generally provide some relief of symptoms within one to two weeks; however, it may take six to eight weeks of treatment before the full effects are seen.
Pharmacology
There are distinct differences between the different classes of antidepressants available because they all work in a different way. In addition, within each class, there are differences between individual antidepressants with regards to how long they remain in the body, how they are metabolized, and how much they interact with other medications.
Tricyclic antidepressants (TCA) and tetracyclic antidepressants (TeCAs)
TCAs and TeCAs work by increasing levels of norepinephrine and serotonin. They may also block the actions of other neurotransmitters, such as acetylcholine and histamine.
Disclaimer: The effects listed below cite the Subjective Effect Index (SEI), an open research literature based on anecdotal user reports and the personal analyses of PsychonautWikicontributors. As a result, they should be viewed with a healthy degree of skepticism.
It is also worth noting that these effects will not necessarily occur in a predictable or reliable manner, although higher doses are more liable to induce the full spectrum of effects. Likewise, adverse effects become increasingly likely with higher doses and may include addiction, severe injury, or death ☠.
Disorientation or confusion
Drowsiness, sometimes insomnia
Excessive sweating
Gastrointestinal upset (such as constipation, diarrhea, or nausea)
A headache
Increased or irregular heartbeat
Low blood pressure when going from a standing to a sitting position (called orthostatic hypotension). In most people, this can be managed by slowly increasing the dosage of the medication, giving split doses, and increasing fluid intake
Sexual dysfunction (such as reduced desire or erectile dysfunction)
Tremor
Urinary retention
Weight loss or weight gain
Disclaimer: The effects listed below cite the Subjective Effect Index (SEI), an open research literature based on anecdotal user reports and the personal analyses of PsychonautWikicontributors. As a result, they should be viewed with a healthy degree of skepticism.
It is also worth noting that these effects will not necessarily occur in a predictable or reliable manner, although higher doses are more liable to induce the full spectrum of effects. Likewise, adverse effects become increasingly likely with higher doses and may include addiction, severe injury, or death ☠.
When taken at the recommended dosage, antidepressants are considered safe. However, some have been associated with severe side effects, some potentially fatal, such as:
An increase in suicidal thoughts and behaviors, particularly in children and young adults under the age of 25 years. This is most likely to occur when starting therapy
An increased risk of seizures in people with a history of seizures
Serotonin syndrome – this is caused by excessive levels of serotonin in the body and is more likely to occur with higher dosages of SSRIs or when SSRIs are administered with other medications that also release serotonin. Symptoms include agitation, confusion, sweating, tremors, and a rapid heart rate
The precipitation of a manic episode in people with undiagnosed bipolar disorder
Duloxetine: A severe discontinuation syndrome
MAOIs: Very severe drug interactions, very severe food interactions, and rarely, rapid but transient increases in blood pressure within 30 minutes to two hours of MAOI ingestion
Nefazodone: Life-threatening liver failure, more common two weeks to six months after starting therapy
SSRIs and vortioxetine: An increase in the risk of bleeding, especially if used with other medications that also increase bleeding risk
TCAs: An increased risk of arrhythmias, heart attacks, stroke, and other cardiovascular effects, particularly in people with pre-existing heart disease; and the triggering of an angle closure attack in people with angle-closure glaucoma
For a complete list of severe side effects, please refer to the individual drug monographs.
