What does it mean when an antidepressant gives you a headache?

October 10, 2025 •

4 min read

Headaches are among the most commonly reported side effects when starting an antidepressant. Understanding what does it mean when an antidepressant gives you a headache? is crucial for managing this discomfort and determining if it is a normal adjustment or a sign of a more serious issue.

Quick Summary

An antidepressant causing a headache is a frequent side effect, particularly during the first few weeks of treatment or after a dosage change. It can relate to neurochemical shifts, withdrawal, drug interactions, or in rare cases, more serious conditions like serotonin syndrome or hyponatremia.

Key Points

Initial Adjustment: Headaches are a common, temporary side effect, often resolving within the first few weeks of starting or changing an antidepressant dose.
Neurochemical Cause: The pharmacological effects of antidepressants, particularly their impact on serotonin levels, can affect blood vessel tone and lead to headaches.
Discontinuation Risk: Stopping an antidepressant abruptly can trigger antidepressant discontinuation syndrome, which frequently includes headaches as a symptom.
Drug Interactions: Combining SSRIs with certain pain relievers (NSAIDs) can increase bleeding risk, while combining with other serotonergic drugs can risk serotonin syndrome.
Red Flags: Severe or persistent headaches accompanied by agitation, confusion, or muscle twitching could signal a medical emergency like serotonin syndrome and require immediate attention.
Management: For mild headaches, staying hydrated, resting, and taking acetaminophen (after consulting a doctor about interactions) can provide relief.

Common Reasons for Antidepressant-Induced Headaches

Experiencing a headache shortly after starting or adjusting an antidepressant is a well-documented phenomenon. For most, this discomfort is temporary and subsides as the body adapts to the medication. However, pinpointing the cause can help you understand what's happening and when to be concerned. The primary reasons relate to the medication's direct pharmacological effects, withdrawal, and potential complications.

Neurochemical Changes During Adjustment

Many antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), work by altering the levels of neurotransmitters like serotonin in the brain. Serotonin plays a complex role in blood vessel constriction and pain perception. As your body adjusts to the new chemical balance, it can cause changes in cerebral blood vessel tone, leading to headaches. This initial adjustment period is where most people experience this symptom.

Antidepressant Discontinuation Syndrome

If you suddenly stop or miss doses of your antidepressant, you may experience withdrawal-like symptoms, including headaches. This is known as antidepressant discontinuation syndrome and can occur with many different types of antidepressants. To prevent this, it's essential to follow your doctor's instructions for tapering off medication gradually.

Hyponatremia (Low Sodium Levels)

In some cases, especially in older adults, antidepressants can interfere with the body's sodium levels, a condition called hyponatremia. Low sodium levels can cause a range of symptoms, including headaches, confusion, and nausea. The risk is highest within the first two to four weeks of starting treatment.

Drug Interactions

Combining antidepressants with other medications can also lead to headaches. For instance, combining an SSRI with non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can increase the risk of bleeding. A more severe, though rare, interaction is serotonin syndrome, which can occur if you take an antidepressant with another medication that also increases serotonin levels, like certain migraine drugs (triptans), other antidepressants, or even herbal remedies like St. John's wort.

Antidepressant Classes and Headache Risk

Not all antidepressants have the same risk profile for causing headaches. Some classes have a higher reported incidence than others, as shown in the table below, summarizing data from clinical studies and patient reports.


Antidepressant Class	Example Drugs	Reported Headache Risk	Notes and Associated Conditions
SSRIs	Escitalopram, Sertraline	Low to Moderate	Associated with a small, statistically significant increase in headache risk compared to placebo; often temporary during adjustment.
SNRIs	Venlafaxine, Duloxetine	Generally Low	Some studies suggest SNRIs may have a lower headache risk than SSRIs, though findings vary.
Atypical	Bupropion (Wellbutrin)	High	Headache is a frequently reported side effect for bupropion users.
Tricyclics	Amitriptyline	Varies	Amitriptyline is sometimes used to treat migraines but can cause headaches as a side effect in some patients.

When to Contact a Doctor about a Headache

While most antidepressant headaches are mild and self-limiting, certain signs and symptoms warrant immediate medical attention. Be on the lookout for "red flag" symptoms that could indicate a more serious condition.

Signs of Serotonin Syndrome

This is a medical emergency and requires immediate care. Symptoms can develop within hours and include:

Agitation or restlessness
Confusion
Rapid heart rate and high blood pressure
Dilated pupils
Muscle rigidity or twitching
High fever
Sweating and shivering
Diarrhea

Symptoms of Severe Hyponatremia

If you have headaches accompanied by any of these, contact your doctor immediately:

Persistent confusion
Weakness
Frequent muscle cramps
Nausea and vomiting
Seizures

Headaches That Don't Improve

If your headaches persist beyond the first couple of weeks, are severe, or worsen over time, consult your prescribing doctor. They may recommend a dosage adjustment or a switch to a different medication.

Managing Antidepressant Headaches

If your doctor has determined that your headache is a normal adjustment symptom, there are several strategies to help manage the discomfort:

Stay Hydrated: Drink plenty of fluids throughout the day.
Rest: Ensure you are getting adequate rest, as fatigue can exacerbate headaches.
Time Your Dose: Taking your medication with or after a meal may help reduce some side effects, including nausea and headaches.
Use OTC Pain Relievers (with Caution): Acetaminophen (Tylenol) can be a safe option for pain relief. However, always consult your doctor before taking NSAIDs like ibuprofen, as they can interact with SSRIs and increase bleeding risk.
Avoid Alcohol: Alcohol can worsen side effects and interact with antidepressants. It's best to limit or avoid it while your body adjusts.

Conclusion: The Bigger Picture

In most cases, a headache from an antidepressant is a temporary side effect of your body adjusting to a new medication. It's a sign that the drug is beginning to work and create changes in your brain's chemistry. This initial discomfort is a small hurdle on the path to improved mental health. However, you should never ignore a persistent, severe, or unusual headache. Maintaining open communication with your prescribing doctor is key to navigating any side effects and finding the best treatment for you. It is important to remember that stopping an antidepressant abruptly can also cause headaches and other withdrawal symptoms, so any changes should always be made under a doctor's supervision. For more information on side effects, the National Institutes of Health provides comprehensive resources.

National Institutes of Health (NIH)

Frequently Asked Questions

Yes, it is very common. Headaches are a frequent side effect, especially during the first one to two weeks as your body adjusts to the medication. This typically resolves on its own.

For most people, the headaches associated with starting a new antidepressant are temporary and should subside within a few weeks. If they persist beyond that, or are severe, you should speak with your doctor.

You should be cautious and consult your doctor or pharmacist first. Acetaminophen is generally considered safer, but NSAIDs like ibuprofen can increase the risk of bleeding when taken with certain antidepressants, particularly SSRIs.

A serious headache might be accompanied by other concerning symptoms, such as confusion, agitation, high fever, or muscle twitching. These could indicate serotonin syndrome, a medical emergency requiring immediate care.

Yes, some antidepressants, like bupropion (Wellbutrin) and some SSRIs (e.g., escitalopram), are more frequently associated with headaches than others. Your doctor can discuss the specific side effect profile of your medication.

Antidepressant discontinuation syndrome is a collection of symptoms, including headaches, that can occur if you stop taking your medication suddenly. Always talk to your doctor before stopping or changing your dose to taper down safely.

Yes. A rare but serious side effect of some antidepressants is hyponatremia, or low blood sodium, which can cause headaches and confusion. This risk is higher in older adults and typically occurs in the first month of treatment.

Ironically, yes. Some antidepressants, particularly certain older tricyclics, are prescribed at lower doses to help prevent migraines and chronic tension headaches, unrelated to their effect on mood.