What Does It Mean When Antidepressants Make You More Anxious at First?

Some people experience increased anxiety, restlessness, agitation, or trouble sleeping after starting an antidepressant. These symptoms are sometimes described as antidepressant activation, but the exact cause is not fully understood. Estimates vary, but these symptoms often begin soon after treatment starts or the dose increases and may improve over the following days or weeks. This can occur with SSRIs such as sertraline and fluoxetine, as well as with other antidepressants. The anxiety may improve as your body adjusts, but contact your prescriber if it is severe, worsening, or difficult to tolerate. Seek urgent help for thoughts of self-harm, extreme agitation or restlessness, unusually elevated mood or reduced need for sleep, or other sudden behavioral changes. Do not change or stop the medication without medical guidance unless emergency care directs you otherwise. Your doctor may adjust the dose or recommend another short-term treatment.