SSRI Side Effects Decoded: Timing, Switching and What Actually Works

SSRIs are among the most widely prescribed medications in primary care, but side effects are one of the top reasons patients stop taking them. Nausea, fatigue, weight gain, and sexual dysfunction can derail treatment before it even has a chance to work. In this episode, we decode the four most common SSRI/SNRI side effect domains and give you a clear, practical framework for managing each one. Learn how to set expectations early, adjust timing, and use targeted strategies to help your patients stay on track and feel better faster. If you’ve ever found yourself guessing how to manage SSRI side effects, this episode gives you the confidence to handle them head-on. For access to the Show Notes as well as the downloadable clinical references and patients handouts associated with this episode, visit the Episode Page. There, if you sign up for a free membership, you'll find: A clinical reference sheet on managing SSRI-related side effects, for quick recall of the topics discussed in this episodes An SSRI comparison table comparing the various antidepressant and their clinical + side effects An SSRI counseling phrase sheet to help you discuss these issues with patients A patient handout on What to Expect When Starting an SSRI A patient handout on Sexual Side Effects from SSRIs For more comprehensive guidance on managing antidepressants and treating depression in primary care, check out our Audio Course Managing Depression in Primary Care. Learning Objectives By the end of this episode, you'll be able to: Recognize the most common early-onset side effects of SSRIs (e.g., GI upset and headaches) and apply evidence-based strategies to counsel patients and manage these symptoms. Differentiate between more activating and more sedating SSRIs, and implement p ractical dosing schedule adjustments to mitigate energy-related side effects. Identify pharmacologic interventions for SSRI-induced sexual dysfunction and weight gain, including when to switch medications versus when to consider adjunctive treatments (e.g., bupropion, buspirone, PDE-5 inhibitors).

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