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Antidepressants Q&As

Published by Bupa's health information team, March 2009.

Answers to questions about antidepressants

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

I have postnatal depression. Can I take antidepressants while breastfeeding?

There is no simple answer to this question as there haven't been very many studies that have looked at the safety of taking antidepressants while breastfeeding. Some antidepressants are believed to be safer for your baby than others when breastfeeding. Your GP will be able to advise you on which is the best antidepressant for you.

Explanation

If you're breastfeeding and have severe depression but don't feel better with counselling or talking therapies, your GP may prescribe you antidepressants. If your GP thinks that you need an antidepressant, he or she will want to consider whether any of the medicine will pass to your baby in your breast milk and if so, whether the medicine will be harmful to your baby. Some antidepressants are thought to be safer for your baby than others.

You can take most tricyclics, except doxepin, if you're breastfeeding, as long as your baby is healthy. Your GP will want to check regularly that your baby isn't affected by the antidepressant. If he or she had too much of a tricyclic, it could cause him or her to be sleepy, or have difficulty breathing.

You can also take the selective serotonin reuptake inhibitors (SSRIs) paroxetine and sertraline if your baby is healthy. Your GP will want to check regularly that your baby isn't affected by the antidepressant.

Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.

Further information

Sources

  • Which antidepressant should I prescribe for a woman who is breastfeeding? Clinical Knowledge Summaries. www.cks.library.nhs.uk, accessed 24 October 2008
  • Joint Formulary Committee, British National Formulary. 56th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2008:824
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Can I drink alcohol if I'm taking antidepressants?

You shouldn't drink alcohol if you're taking antidepressants because alcohol can make your depression worse and can make you slow and drowsy. Also, some antidepressants mustn't be taken with alcohol because together they can cause serious side-effects. Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.

Explanation

If you're taking antidepressants you shouldn't drink alcohol at all. Alcohol on its own can make your depression worse, but it can also make you slow and drowsy if you're taking antidepressants. This can lead to problems with driving - or with anything else you need to concentrate on. Most manufacturers of antidepressants recommend that you don't drink alcohol when you're taking antidepressants because of the risk of drowsiness.

Some foods and alcoholic drinks contain a substance called tyramine, which can cause a dangerous increase in blood pressure in people taking a type of antidepressant called a monoamine oxidase inhibitor. You shouldn't drink alcohol if you're taking this type of antidepressant.

Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.

Further information

Sources

  • Antidepressants. Royal College of Psychiatrists. www.rcpsych.ac.uk, accessed 24 July 2008
  • Making sense of antidepressants. Mind. www.mind.org.uk, accessed 24 July 2008
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Are there any antidepressants that can be prescribed for children and teenagers?

If your child has been diagnosed with depression, your doctor may suggest that he or she has psychological, or talking therapy, before prescribing antidepressants. Most antidepressants that are used to treat depression in adults aren't suitable for children and teenagers. If your doctor thinks that your child needs to take antidepressants, he or she will probably be prescribed fluoxetine (Prozac), which is the only antidepressant where the benefits of treatment are believed to be greater than the risks.

Explanation

Children and teenagers can become depressed. This can cause problems with their mood, thinking, and behaviour at home, in school and with their friends. If your child has been diagnosed with depression, your doctor may suggest that he or she has psychological therapy, or talking therapy, before prescribing antidepressants. If this doesn't work, your doctor may decide that your child needs antidepressants. It's important that you're aware that most antidepressants used to treat depression in adults aren't suitable for children and teenagers. This is because they haven't been tested in children and doctors don't know if they will work or if they are safe.

In the UK, there are guidelines to help doctors decide whether antidepressants are the best treatment for your child. If your child has mild depression, it's unlikely that your doctor will prescribe antidepressants because psychological therapies are usually better for this condition than medicines. Your doctor will also recommend a psychological therapy for at least three months if your child has more severe depression. If this doesn't work, your doctor may then consider antidepressants. In most cases, your child should continue with the psychological therapy even if your doctor has prescribed antidepressants.

The UK guidelines recommend that an antidepressant called fluoxetine (Prozac) is tried first. Fluoxetine is the only antidepressant where the benefits of treatment in children and young adults are believed to be greater than the risks. Your child may not show an immediate improvement with fluoxetine because it usually takes two to four weeks before antidepressants improve symptoms. For this reason, your doctor will usually suggest that your child takes fluoxetine for at least eight weeks.

Your doctor will want to see your child regularly to check that he or she is making good progress and that the medicine isn't causing any serious side-effects.

If fluoxetine isn't helping your child, your doctor may prescribe another antidepressant, such as sertraline (Lustral) or citalopram (Cipramil).

Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.

The UK guidelines don't recommend treating children and young adults with a type of antidepressant called a tricyclic, or with the antidepressants paroxetine and venlafaxine.

St John's wort is sold as a herbal antidepressant. There have been no studies looking at whether it helps depression in children or if it's safe in children. It's known that St John's wort can cause problems when taken with other medicines, including contraceptives. If your child is taking St John's wort for depression, you should talk to your doctor about stopping it and about alternative treatments.

Further information

Sources

  • Depression in children and young people: quick reference guide. National Institute for Health and Clinical Excellence (NICE), 2005. www.nice.org.uk
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Related topics

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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: March 2009

 

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