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Weight gain, emotional numbness, and sexual side effects are among the most common reasons people stop taking antidepressants. They are real, they are documented in large studies, and they are not a sign that you failed the medication. If side effects have pushed you off two or more antidepressants that were otherwise dosed correctly, you may qualify for treatment options that do not involve another daily pill, and many of them are covered by insurance.
On this page: Which side effects are most common? · Why do I feel numb? · Is stopping on my own risky? · What are the alternatives? · Will insurance cover them?
Sexual side effects lead the list. A meta-analysis of treatment-emergent sexual dysfunction found rates between roughly 25 and 80 percent depending on the medication, with SSRIs and venlafaxine at the higher end (Serretti and Chiesa, J Clin Psychopharmacol 2009, PMID 19440080).
Weight change is second. Some agents, particularly mirtazapine and paroxetine, are associated with meaningful weight gain over months of use, while others are close to weight neutral (Serretti and Mandelli, J Clin Psychiatry 2010, PMID 20868636). Which medication you are on matters, so a switch is sometimes enough.
Others worth naming: nausea in the first weeks, sleep changes, daytime fatigue, and sweating. Most early side effects fade. Sexual side effects, weight gain, and emotional blunting tend not to.
Emotional blunting means the lows are gone but so are the highs. You do not cry, but you also do not feel much at a wedding or with your kids. In a survey of medicated patients with depression, about 46 percent reported some degree of emotional blunting (Goodwin et al, J Affect Disord 2017, PMID 28531848).
Blunting is worth reporting rather than tolerating. It can reflect the medication, or it can be a residual symptom of the depression itself. Those two possibilities lead to different next steps, and telling them apart is exactly what a medication review is for. If you are local to the East Bay, our treatment-resistant depression evaluation looks at this question directly.
Stopping abruptly can cause discontinuation symptoms, including dizziness, irritability, sleep disruption, and a fast return of depression. If side effects are the problem, the safer sequence is to tell your prescriber what you are experiencing and taper or switch on a schedule. You have more options than staying miserable or quitting cold.
Three realistic paths, often used together:
Switching within medications. Side effect profiles differ by agent. Bupropion, for example, has lower rates of sexual dysfunction and weight gain than most SSRIs. A switch is the simplest move and is usually tried first.
Adding therapy. Structured psychotherapy can allow a lower medication dose or, for some people, no medication at all after recovery.
TMS (transcranial magnetic stimulation). TMS is an FDA-cleared, non-medication treatment for major depression. Because it works by magnetic stimulation of a specific brain region rather than through your bloodstream, it does not cause weight gain, sexual dysfunction, or emotional blunting. The most common side effect in trials was scalp discomfort at the treatment site, and dropout due to side effects was low (O’Reardon et al, Biol Psychiatry 2007, PMID 17573044). Not everyone responds, and it requires daily weekday visits for several weeks. If the side effect burden of pills is what keeps ending your treatment, this trade is worth understanding. Here is how candidacy is assessed.
Often yes, with conditions. Most California plans cover TMS for major depression after you have had an inadequate result from antidepressant trials, and in many cases a trial stopped because of intolerable side effects counts toward that requirement. Documentation of what you tried and why it ended matters, which is another reason to switch or stop with your prescriber rather than alone. Coverage details by plan are in our TMS insurance coverage guide.
In the STAR*D trial, each additional medication attempt after the second brought diminishing returns (Rush et al, Am J Psychiatry 2006, PMID 17074942). If you are two or more medications in and side effects keep ending the attempt, it is reasonable to ask about a different kind of treatment rather than a fourth pill. A consultation at Exxceed Wellness in Hayward can review your medication history and lay out which options your plan covers. Telehealth evaluations are available across California.
This article is educational and is not a substitute for personalized medical advice. Treatment decisions, including stopping or changing a medication, should be made with your own clinician. Reviewed by Nefretiri Abat, PMHNP-BC, JD.
