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For adults starting an antidepressant such as escitalopram, sertraline, fluoxetine or mirtazapine, and for their family.

Drawing: The tablets, a calendar ticked week by week, a sunrise, and a plant beginning to grow. — The tablets, a calendar ticked week by week, a sunrise, and a plant beginning to grow.

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Patient's name Date Your medicine and dose

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What to expect, week by week

Week 1 to 2Side effects come first: nausea, loose motions or constipation, headache, sweating, poor sleep or sleepiness, feeling restless or more anxious. These usually ease within a couple of weeks. Sleep and appetite often begin to improve. The first review is usually within these 2 weeks, and earlier for people under 25. Keep the appointment.
Week 2 to 4Mood starts to lift. Others may notice the change before you do.
Week 4 to 8The full effect. If there is no benefit at all by 4 weeks, tell the doctor: the dose or the medicine may need to change.
After you are wellContinue for at least 6 months after you feel well. Longer if you have had repeated episodes. Stopping as soon as you feel better is the commonest reason the illness returns.

Taking it

Take it once a day, at the same time. If it keeps you awake, take it in the morning. If it makes you sleepy, take it at night.
Taking it after food reduces nausea.
Missed a dose? Take it when you remember, unless it is nearly time for the next one. If it is a night-time medicine and you remember the next morning, skip it. Never take two together.
Avoid alcohol. Do not drive or operate machines if you feel drowsy or dizzy.

Do not stop it suddenly

Antidepressants do not cause a strong urge to take more, and you will not need higher and higher doses. But the body gets used to them. Stopping suddenly can cause dizziness, electric-shock sensations, irritability, anxiety, poor sleep, nausea and sweating. When it is time to stop, your doctor will reduce the dose in steps, over weeks or months.

Contact your doctor the same day if

You feel much more restless, anxious or disturbed than before
You feel unusually excited or overactive, talk much more than normal, or need very little sleep
An older person becomes confused, drowsy or unsteady
You have unusual bruising or a new rash

Do not stop the medicine on your own. The doctor may change the dose or the medicine.

Get help now if

Thoughts of harming yourself appear or get stronger. This is uncommon. It can happen in the first weeks, more often in people under 25.
You have a fast heartbeat with sweating, shaking, twitching muscles, fever or confusion
You have black stools, or blood in vomit or urine
You have a fit
Your face or lips swell, or you have difficulty breathing

If you have thoughts of harming yourself, or feel unsafe: tell someone close to you now and do not stay alone. Call Tele-MANAS on 14416 (free, 24 hours, in Indian languages), or go to the nearest hospital with an emergency department. If you have already harmed yourself, or are in immediate danger, call 108. Family: stay with the person, listen, and take them for help. For the other signs, call 108 or go to the nearest hospital with an emergency department.

Tell your doctor about

Every other medicine you take, especially painkillers (tramadol, ibuprofen, aspirin), migraine medicines, blood thinners, other antidepressants, and herbal or unani products
Pregnancy, plans for pregnancy, or breastfeeding. Do not stop the medicine on your own: discuss it first.
Sexual side effects or weight change. These are common, they matter, and there are ways to manage them.

For the family: recovery is gradual and uneven. Good days and bad days are normal in the first weeks. Help the person take the medicine daily and keep the review appointment.

Questions about this sheet? Call Caspian Healthcare reception on +91 89193 41154. A doctor is on duty at all hours for problems that are not critical. Caspian has no emergency department: in an emergency call 108.

Where this comes from

Prepared by Caspian Healthcare from the sources above. Last reviewed October 2026. General information: your own doctor's written instructions come first.