Minimizing and managing antidepressant side effects.

Side effects often complicate the use of antidepressants for treatment of patients with major depression. Aggressive minimization and management of antidepressant side effects may relieve discomfort and distress, improve quality of life, enable clinicians to use appropriate medications at therapeutic doses, improve compliance, and thus enhance overall outcome. In this article we present recommendations for the management of side effects associated with antidepressant medications. Specifically, strategies are provided for the management of anticholinergic, cardiovascular, sedative, and activating side effects. Strategies for the management of antidepressant-associated insomnia, hypomania and mania, sexual dysfunction, appetite stimulation and weight gain, cognitive impairment, and parathesias are also discussed.