Key points from the chart
- The chart rates 14 antidepressants on seven side effects, using a scale from 0 (none) to 4 (high).
- Paroxetine and amitriptyline score 4 for sexual dysfunction. Bupropion scores 0.
- Mirtazapine and amitriptyline score 4 for weight gain. Fluoxetine, vortioxetine, bupropion and agomelatine score 0.
- Trazodone, mirtazapine and amitriptyline score 4 for drowsiness. Citalopram has the highest QTc prolongation score, 3.
- The chart’s own notes say side effects are highly individual and the scores describe risk in the general population. It names UpToDate as its source.
The antidepressant side effects chart in text
Scores as printed on the WhatMedicine.Org chart. A value such as “1 to 2” is printed on the graphic as “1 / 2” and means the risk sits between the two levels.
| Antidepressant | Sexual dysfunction | Gastrointestinal discomfort | Weight gain | QTc prolongation | Hypotension | Insomnia | Drowsiness |
|---|---|---|---|---|---|---|---|
| Sertraline | 3 | 2 | 1 | 1 to 2 | 1 | 2 | 0 |
| Paroxetine | 4 | 1 | 2 | 0 to 1 | 2 | 1 | 1 |
| Citalopram | 3 | 1 | 1 | 3 | 1 | 1 | 0 |
| Escitalopram | 3 | 1 | 1 | 2 | 1 | 1 | 0 |
| Fluoxetine | 3 | 1 | 0 | 1 | 1 | 2 | 0 |
| Fluvoxamine | 3 | 1 | 1 | 1 | 1 | 1 | 1 |
| Vortioxetine | 1 | 3 | 0 | 0 | 0 | 0 | 0 |
| Trazodone | 1 | 3 | 1 | 1 to 2 | 3 | 0 | 4 |
| Bupropion | 0 | 1 | 0 | 1 | 0 | 2 | 0 |
| Venlafaxine | 3 | 2 | 0 to 1 | 1 to 2 | 0 | 1 | 1 |
| Duloxetine | 1 | 2 | 0 to 1 | 0 | 0 | 1 | 0 |
| Mirtazapine | 1 | 0 | 4 | 1 | 0 | 0 | 4 |
| Agomelatine | 0 to 1 | 1 | 0 | 0 | 0 | 1 | 1 |
| Amitriptyline (printed “Amitryptyline”) | 4 | 1 | 4 | 1 to 2 | 3 | 0 | 4 |
Scale: 0 = none, 1 = slight, 2 = low, 3 = moderate, 4 = high. On the graphic the numbers are coloured from green (0) through yellow and orange to red (4).
Notes printed under the chart:
- Side effects from antidepressants are highly individual. This chart represents a risk of side effects in the general population.
- Gastrointestinal side effects from SSRIs and SNRIs commonly subside within the first weeks of treatment.
- Starting any antidepressant may initially increase the risk of suicidal ideation and behaviour in children, adolescents and young adults.
- Source: uptodate.com. Copyright 2023 by WhatMedicine.Org, “Database and Short-Form Articles for Psychiatric Medications”.
What the seven side effects mean
WhatMedicine.Org’s article explains each column [1]. Sexual dysfunction covers reduced libido, erection problems and difficulty with orgasm. Gastrointestinal discomfort covers nausea, vomiting, diarrhoea and stomach pain, which the article says commonly subside after 1 to 2 weeks. QTc prolongation is a change in the heart’s electrical cycle that can lead to irregular heartbeats, which matters most for people with existing heart conditions. Hypotension is low blood pressure, and insomnia and drowsiness are sleep effects in opposite directions.
The article also says a 4 does not mean a person will get that side effect, and a 0 does not rule it out. It gives escitalopram as an example: rated 0 for drowsiness, although fatigue and somnolence are among its more commonly reported side effects [1].
How the chart compares with NHS information
The NHS lists common side effects of antidepressants including difficulty sleeping, weight gain, headaches, dry mouth, feeling sick, feeling dizzy or drowsy, and problems with sex such as low sex drive or difficulty reaching orgasm. It says that for some people the sexual problems may carry on after stopping [2]. It also says many side effects may ease after a couple of weeks, that the possible side effects depend on the type of antidepressant, and that some people may have suicidal thoughts when they start, with people aged 24 or under most at risk [2].
The NHS medicine pages agree with several of the chart’s high scores. Sexual problems such as low sex drive are listed as a common side effect of sertraline and citalopram [3][4]. Mirtazapine’s common side effects include feeling drowsy and wanting to eat more than usual and putting on weight [5]. Trazodone’s include feeling sleepy, dizzy or tired [6], and the NHS says amitriptyline can make you feel sleepy and can reduce your blood pressure when you stand up [7]. For citalopram, the NHS names a rare, life threatening fast and irregular heartbeat (torsades de pointes) as a serious side effect and asks people with heart rhythm problems to tell their doctor before taking it [4], which fits the chart’s QTc score.
The NHS advises talking to a doctor before stopping any antidepressant, and reporting suspected side effects through the Yellow Card scheme [2].
Notes on this infographic
- Spelling. The chart prints “Amitryptyline”. The usual spelling, used by the NHS, is amitriptyline [7].
- No drug classes. The chart lists drug names only. It does not label which are SSRIs, SNRIs or tricyclics, so this page does not add class labels to the scores.
- Scores are a summary. The 0 to 4 scores are WhatMedicine.Org’s own grading based on UpToDate, which is a subscription service we could not open. We have checked the high scores against NHS pages but not every cell.
- Not a complete list. WhatMedicine.Org says the chart leaves out other common side effects, such as excessive sweating, dry mouth and headaches [1].
- Medical advice. This page describes the chart. It is not a guide to choosing a medicine. Decisions about antidepressants should be made with a doctor or pharmacist.
Questions about antidepressant side effects
Which antidepressant has the lowest side effects?
On this chart, bupropion and agomelatine have the lowest scores overall, mostly 0 and 1. Bupropion still scores 2 for insomnia. The chart notes that side effects are highly individual [1], and the NHS says the possible side effects depend on the type of antidepressant [2].
What is the main side effect of antidepressants?
There is no single main side effect. The NHS lists common ones including difficulty sleeping, weight gain, headaches, dry mouth, feeling sick, dizziness or drowsiness, and sexual problems [2]. On this chart, sexual dysfunction has the most scores of 3 or 4.
Do sexual side effects of Zoloft go away?
Zoloft is a brand name for sertraline, which scores 3 for sexual dysfunction on the chart. The NHS says most sertraline side effects ease after a couple of weeks but some can last longer [3], and that for some people sexual problems may carry on after stopping antidepressants [2].
Sources
- WhatMedicine.Org, The Antidepressants Side Effects Chart.
- NHS, Antidepressants, side effects (page last reviewed 12 June 2025).
- NHS, Side effects of sertraline.
- NHS, Side effects of citalopram.
- NHS, Side effects of mirtazapine.
- NHS, Side effects of trazodone.
- NHS, Side effects of amitriptyline for depression.
Last reviewed 29 October 2026
