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Side Effects · Private Psychiatric Review UK

Antidepressant side effects —
you don't have to accept them

Sexual dysfunction, emotional blunting, weight gain, brain fog. These are real side effects — not personal failings — and they deserve a proper clinical conversation.

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GMC RegisteredExperienced Psychiatrists
FRCPsych, MRCPscyhRoyal College Fellow, Member
CQC RegulatedRegistered Clinic

Side effects that often go unacknowledged

Things you may have been told are not the medication

"I feel emotionally flat — like I can't feel joy or grief properly. Things that used to matter to me just feel distant."

"My sexual function has changed significantly since starting the medication. It's affecting my relationship and my sense of self."

"I've gained significant weight and I don't know if it's the medication or something else. My GP doesn't seem sure either."

"I feel like I'm thinking through fog — my memory and concentration aren't what they were. I'm not sure if that's depression or the treatment."

Taking side effects seriously

Common antidepressant side effects that deserve clinical attention

Antidepressant side effects are real, common and frequently under-reported — partly because patients assume they must be tolerated, and partly because they are sometimes dismissed as unrelated to the medication. They are not trivial. They affect quality of life, relationships and the willingness to continue treatment.

60% of antidepressant users report sexual side effects — the most commonly cited reason for stopping medication without medical advice Clinical literature
46% of people on SSRIs report emotional blunting — feeling less able to experience the full range of emotions, positive or negative Goodwin et al, 2017
1 in 4 people on antidepressants report significant weight gain — a factor rarely discussed adequately at prescribing UK Biobank data

The most clinically significant side effects of common antidepressants include:

  • Emotional blunting — sometimes called "emotional anaesthesia"; a reduction in the intensity and range of emotional experience, affecting both positive and negative emotions
  • Sexual dysfunction — reduced libido, delayed orgasm or anorgasmia, genital numbness; these effects can persist beyond the period of use (post-SSRI sexual dysfunction, or PSSD)
  • Weight gain — most common with mirtazapine, paroxetine and amitriptyline; less so with sertraline and fluoxetine
  • Cognitive effects — difficulty concentrating, word-finding problems, memory gaps, a sense of mental slowing
  • Sleep disruption — vivid dreams, insomnia, excessive sedation depending on the medication
  • Sweating and temperature dysregulation — often nocturnal; frequently not attributed to the medication
  • Gastrointestinal effects — nausea (usually settles), diarrhoea, appetite changes
Side effects that significantly affect quality of life are not a price that must be paid for stability. They are a clinical problem that deserves a clinical solution.

You deserve a proper answer

Side effects are not just
something to live with

A psychiatric review can clarify what is causing what — and whether there are better options available to you.

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Common questions

Questions people often ask

This is one of the most important and most difficult clinical questions in psychiatry — and it rarely gets the attention it deserves in short GP appointments. A careful psychiatric review, taking a timeline of when symptoms appeared relative to medication changes, is the most reliable way to distinguish the two. We do this as a matter of course.
For some side effects — particularly nausea — this is often true. For others, particularly sexual dysfunction and emotional blunting, the evidence suggests they frequently persist for as long as the medication is taken, and in some cases beyond. If you have been told to wait and the side effects have not improved after several months, that conversation needs revisiting.
Options include: dose reduction (which can sometimes reduce side effects while maintaining therapeutic benefit), switching to a different antidepressant with a different side effect profile, adding an adjunctive treatment to manage the side effect specifically, or — if the clinical picture supports it — a carefully planned taper and stop. The right option depends on your individual situation and why you are on the medication.
PSSD is a recognised condition in which sexual dysfunction — including genital numbness, reduced libido, delayed or absent orgasm — persists after stopping an SSRI or SNRI. It is not yet fully understood, but it is real and has been included in the European Medicines Agency's regulatory guidance. We take it seriously and can discuss it as part of a clinical review.

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