Advise patients that benefits should be felt within four weeks, but there may be side effects, and some people may find it difficult to later stop using an antidepressant.¹⁴

Gastrointestinal symptoms such as diarrhoea, nausea, indigestion, dry mouth or changed appetite can be common as can headache, fatigue or insomnia, and disturbed sleep. People with type 2 diabetes may find glycaemic control alters.^11,14

There is a potential increased risk of suicidal thoughts, self-harm and suicide in the early stages of antidepressant treatment (see below). Some patients may experience increased anxiety symptoms (paradoxical anxiety) when starting antidepressants. This usually subsides within the first two weeks. ^11,14

SSRIs and SNRIs have also been associated with akathisia or psychomotor restlessness, an unpleasant state of restlessness with a strong feeling of the need to keep moving and an inability to sit or stand still. This often starts early on with treatment, although is more likely with antipsychotics.^11,17

Antidepressants should be used with caution if the patient has a history of mania, bipolar disorder and/or seizures. An antidepressant should be discontinued if such a patient appears to be entering a manic phase or develops seizures.¹¹