What you need to know about going on - and coming off - antidepressants

As antidepressant use rises in the UK, the family of Thomas Kingston, who was married to King Charles III’s second cousin, has called for more information to be given to patients about the side effects.

It comes after Kingston, whose wife is the Prince and Princess Michael of Kent’s daughter Lady Gabriella Kingston, died from a head injury on 25 February at his parents’ home in the Cotswolds. A gun was found near his body.

The inquest into his death revealed that Kingston had been taking sertraline, a common antidepressant, and zoplicone, a sleeping tablet. He was prescribed the medications after experiencing stress and trouble sleeping.

He was later prescribed citalopram, another antidepressant. He stopped taking the medication in the days leading up to his death. The coroner said that Kingston had been "suffering adverse effects of medication he had recently been prescribed".

Kingston’s parents, Martin and Jill Kingston, said that patients should be given more explicit information about the potential side effects of selective serotonin reuptake inhibitors (SSRIs), which are a type of antidepressant that is widely used.

Speaking to BBC Radio 4’s Today programme, Martin suggested that patients should sign a document confirming they have been informed about what could happen when going on the medication and coming off of it.

Here’s everything you need to know about antidepressants.

What kind of antidepressants are available?

SSRIs are a widely used type of antidepressant, mainly prescribed to treat depression in particularly persistent or severe cases. It is usually utilised in combination with a talking therapy.

The NHS says that SSRIs are usually the first choice medication to treat depression because they "generally have fewer side effects than most other types of antidepressant".

They work by increasing serotonin levels in the brain. Serotonin influences mood, emotions and sleep in a positive manner, and a rise in serotonin levels can help people suffering from depression and some other mental health conditions feel better and improve their symptoms.

In the UK, there are eight types of SSRIs prescribed by the NHS. These include:

• Citalopram (Cipramil)

• Dapoxetine (Priligy)

• Escitalopram (Cipralex)

• Fluoxetine (Prozac/Oxactin)

• Fluvoxamine (Faverin)

• Paroxetine (Seroxat)

• Sertraline (Lustral)

• Vortioxetine (Brintellix)

What are the side effects of antidepressants?

Common side effects of SSRIs can include:

• Feeling agitated, shaky or anxious

• Diarrhoea and feeling or being sick

• Dizziness

• Blurred vision

• Loss of libido

• Difficulty achieving orgasm during sex or masturbation

• Difficulty obtaining or maintaining an erection

For most people, the side effects of SSRIs are mild. You will need to see your doctor every few weeks when you start taking them to talk about whether the medication is working for you. You should contact your doctor if you experience troublesome or persistent side effects.

What happens when you stop taking antidepressants?

If you wish to stop taking antidepressants, it’s important that you do not do so suddenly. You should speak to your doctor before you stop taking the medication.

Stopping antidepressants abruptly can cause serotonin levels in the body to change rapidly and cause symptoms that are known as withdrawal symptoms.

Symptoms of withdrawal can include:

• Restlessness

• Trouble sleeping

• Unsteadiness

• Sweating

• Stomach problems

• Feeling as if there’s an electric shock in your head

• Changes to your mood, such as low mood, irritability, anxiety and confusion

The Royal College of Psychiatrists states that between a third and a half of people who take antidepressants will be affected by ADS if they suddenly stop taking their medication.

The organisation urges patients to gradually wean off antidepressants with the help and advice of their doctor. Every person is different and the withdrawal plan must be flexible in order to allow you to reduce the dose at a rate you find comfortable.

If you need support for your mental health, you can contact Mind for information and support on 0300 123 3393 or email the charity at info@mind.org.uk.

Read more about mental health:

• Six ways antidepressants affect children and young people (Yahoo Life UK, 7-min read)

• Why resilience won’t solve the mental health crisis among young people (The Conversation, 5-min read)

• Touch can help improve feelings of pain or depression, study suggests (PA Media, 2-min read)