Managing Medication Side Effects
Practical strategies for common psychiatric medication side effects: what to try, when to call your doctor, and how to work together on solutions.
Clinically Reviewed: Board-Certified Psychiatrist |Next Review: November 2025
Key Takeaways
- Most medication side effects are mild and improve within 1-2 weeks
- Many side effects have practical management strategies you can try
- Never stop medication abruptly due to side effects—contact your doctor first
- Some side effects (sexual, weight) may persist and require medication adjustment
- Your psychiatrist can modify dose, timing, or switch medications to improve tolerability
Common Side Effects & Solutions
Nausea & Stomach Upset
Why it happens: SSRIs affect serotonin receptors in your gut
What to try:
- Take medication with food
- Start with half dose for first week if doctor approves
- Take ginger or use anti-nausea medication temporarily
- Usually improves within 1-2 weeks
Sexual Side Effects
Why it happens: Increased serotonin can affect sexual function
What to try:
- Wait 4-6 weeks—sometimes improves over time
- Lower the dose (if depression is well-controlled)
- Add bupropion (often helps counter sexual effects)
- Switch to bupropion or mirtazapine (fewer sexual side effects)
- Consider 'drug holidays' (talk to doctor first—not always safe)
Insomnia or Sedation
Why it happens: Different medications affect sleep differently
What to try:
- If insomnia: Take medication in morning instead of evening
- If sedation: Take at bedtime instead of morning
- Practice good sleep hygiene (see CBT-I guide)
- Discuss adding trazodone or switching medications if persistent
Weight Changes
Why it happens: Some medications affect metabolism and appetite
What to try:
- Monitor diet and exercise (depression recovery often increases appetite naturally)
- Switch to weight-neutral option (bupropion, fluoxetine)
- Add metformin if metabolic concerns develop
- Discuss with doctor before significant weight gain occurs
Frequently Asked Questions
How long do side effects last?
Most initial side effects (nausea, jitteriness, headache) improve within 1-2 weeks as your body adjusts. Some side effects (sexual dysfunction, weight changes) may persist longer and require addressing with your doctor.
Should I stop my medication if I have side effects?
No, don't stop abruptly. Many side effects are temporary and improve with time. Contact your doctor to discuss—they can adjust timing, dose, add supportive medications, or switch to a different antidepressant if needed.
Can I take other medications to manage side effects?
Sometimes. For nausea, anti-nausea medications may help initially. For sexual side effects, medications like bupropion can be added. Always check with your doctor before adding anything, including over-the-counter medications or supplements.
What if side effects are unbearable?
Contact your psychiatrist right away. Intolerable side effects mean the medication isn't the right fit for you. Your doctor can switch you to a different medication with a better side effect profile for your situation.
Do side effects mean the medication is working?
Not necessarily. Side effects just mean your body is responding to the medication. You can have side effects without mood benefit, or mood benefit without side effects. They're not reliable indicators of therapeutic response.
Can I drink coffee or caffeinated beverages?
Usually yes, but caffeine may worsen jitteriness or anxiety if you're on activating antidepressants. If you notice increased anxiety or sleep problems, consider reducing caffeine intake and see if symptoms improve.
Will side effects come back if I increase the dose?
Possibly, but often milder than when you first started. When increasing doses, you may experience a brief return of side effects that typically resolve within days to a week.
Are generic medications different from brand-name?
Generics contain the same active ingredient and are FDA-required to be equivalent. However, inactive ingredients (fillers) differ, which rarely causes different side effects. If you notice changes after switching, tell your doctor.
References
- 1. Ferguson JM. (2001). "SSRI antidepressant medications: adverse effects and tolerability." Primary Care Companion J Clin Psychiatry 3(1):22-27.
- 2. Cassano P, Fava M. (2002). "Tolerability issues during long-term treatment with antidepressants." Annals of Clinical Psychiatry 14(4):223-232.