Depression and anxiety

Which medicines are prescription-only

Every antidepressant is prescription-only in Ireland, and so is every antipsychotic used in mood or anxiety disorders. The groups you are most likely to be on are SSRIs such as sertraline, escitalopram, fluoxetine, citalopram and paroxetine; SNRIs such as venlafaxine and duloxetine; and mirtazapine, which sits on its own. Quetiapine and aripiprazole are antipsychotics that are sometimes prescribed alongside an antidepressant.

None of these are controlled drugs, which is why they can be renewed on an ordinary prescription. Benzodiazepines and Z-drugs, which are sometimes given for short-term anxiety or insomnia, are a different legal category and are not available through this route at all. Melatonin is prescription-only in Ireland in its licensed forms. What you can buy without a prescription is limited to supplements with no established role in treating a diagnosed depressive or anxiety disorder, and St John's wort, which interacts with a long list of prescribed medicines and should never be added quietly.

How long antidepressants take to work

Two to six weeks is the usual answer for a meaningful change in mood, and up to eight to twelve weeks for the full effect of a given dose. Sleep and appetite often shift first, and energy sometimes returns before mood does, which is a period that needs watching rather than celebrating. Anxiety symptoms can be slower still and sometimes get briefly worse before they settle.

That delay explains most of the treatment failures people describe. Stopping after ten days because nothing has happened is stopping before the medicine has had a chance; equally, staying on a dose for six months with no benefit is waiting too long. The sensible pattern is a planned review with your prescriber after the first few weeks, then again once a dose has settled. Alcohol works against all of this, and disturbed sleep does too, so the medicine is rarely the only variable worth adjusting.

The warning that matters most in the first weeks

In the first weeks of treatment, and after any change of dose, anxiety, agitation and thoughts of self-harm or suicide can increase before the medicine helps. This is set out in the product information for antidepressants and it is clearest in people under 25. It does not mean the medicine is wrong; it means the early phase needs closer contact with a clinician, not less.

What to do with that is practical. Tell somebody close to you that you are starting or changing treatment, so a change in you is noticed by more than one person. Arrange a review point in the first weeks rather than leaving it open. If agitation, restlessness or thoughts of harming yourself appear or intensify, contact your prescriber or your GP without waiting for the next scheduled contact. If you feel unsafe now, ring 112 or 999, go to the nearest Emergency Department, or ring Samaritans free on 116 123 at any hour of the day or night. Text About It can be reached by texting 50808.

Common side effects and what usually settles

The first week or two is often the worst of it. Nausea, headache, dry mouth, restlessness, disturbed sleep and vivid dreams are common with SSRIs and SNRIs and usually ease. Mirtazapine tends to cause sedation and increased appetite, which is why it is often taken at night and why it is sometimes chosen deliberately for someone who is not sleeping or eating.

Some effects do not settle and are worth naming rather than tolerating in silence. Sexual side effects, including reduced desire, delayed orgasm and erectile difficulty, are common with SSRIs and SNRIs and are a frequent unspoken reason people stop. Sweating, weight change and emotional blunting also persist for some people. Venlafaxine can raise blood pressure at higher doses. All of these are dose-related or drug-specific often enough that a change is worth discussing, and none of them are a reason to stop overnight on your own.

Stopping treatment and why it is done gradually

Stopping abruptly commonly produces discontinuation symptoms: dizziness, electric-shock sensations, nausea, irritability, vivid dreams, flu-like aches and a sudden return of anxiety. They are more likely with medicines that leave the body quickly, such as paroxetine and venlafaxine, and less likely with fluoxetine, which clears slowly. They are unpleasant rather than dangerous, but they are also easily mistaken for the original illness coming back, which sends people into decisions they would not otherwise make.

The way around them is a gradual reduction planned with your prescriber, with the pace set by how you tolerate each step rather than by a calendar. Treatment for a first episode of depression is usually continued for a period after recovery rather than stopped as soon as you feel well, because stopping at the point of recovery is associated with relapse. If you are stopping because of side effects, cost or simply being tired of taking tablets, say that out loud to your prescriber: all three have solutions that are better than stopping suddenly.

Are antidepressants addictive

They are not addictive in the sense that matters. Antidepressants do not produce craving, do not produce escalating dose-seeking and are not misused for effect. What they do produce, on stopping, is physical discontinuation symptoms, and the confusion between dependence and discontinuation is the source of most of the fear around them.

The distinction is worth holding on to because the medicines that are genuinely habit-forming in this space are different ones. Benzodiazepines and Z-drugs cause tolerance and dependence within weeks, which is exactly why they are controlled and why they are prescribed for short defined periods when they are prescribed at all. If somebody has been taking one of those for months, that is a conversation with a GP about a planned reduction, not something to solve online. MEDINOW does not prescribe benzodiazepines, Z-drugs, stimulants or gabapentinoids under any circumstances.

Renewing established treatment without a gap

The most common practical problem in this area is not the diagnosis, it is running out. A gap of several days in an SSRI or SNRI usually means discontinuation symptoms and a setback that takes weeks to recover, so the aim is continuity rather than heroics.

MEDINOW runs a written repeat prescription assessment at 19.90 euro for treatment you are already established on: same substance, same strength, same dose, condition stable. You complete a medical questionnaire and a doctor reads it and answers in writing. There is no video consultation, no phone appointment and no live chat. We do not start antidepressant treatment and we do not change doses, because both need a clinician who can follow you through the first weeks. Have your last prescription or dispensing label to hand, and say when the treatment was last reviewed. The fee covers the medical assessment itself, not the issuing of a document. If the doctor declines on medical or legal grounds, the fee is refunded. If the doctor asks you for documentation, you have at least 7 days to provide it and we will remind you before the deadline; if the consultation cannot be completed, we refund the full amount.

What is outside this route entirely

Some groups of medicine are excluded and no questionnaire changes that. Benzodiazepines, Z-drugs for sleep, stimulants, gabapentinoids such as pregabalin and gabapentin, and medical cannabis are not prescribed by MEDINOW. Article 11(6) of Directive 2011/24/EU allows member states to keep narcotic and psychotropic medicines out of the cross-border prescription route, and Irish rules keep controlled drugs out of it as well.

Two further limits are clinical rather than legal. We do not begin treatment for depression or anxiety, and we do not adjust a dose that is in the middle of being titrated, because both require somebody who can see you again in a fortnight. Talking therapy is not something we provide either; your GP can refer you, and the HSE publishes what is available locally along with the free and low-cost supports. If your mood has been worsening, if you are drinking more to cope, or if the thought of harm has entered the picture, a person is what you need, not a form.

Who wrote this page

This page was written by the MEDINOW editorial team and reviewed by lek. Damian Wojno, a doctor registered in Poland, PWZ no. 3211301. He is not on the Irish Medical Council register. Reviewed on 29 August 2026.

It is general information about medicines used in depression and anxiety, not a diagnosis and not advice about your own treatment. The warnings, contraindications and side effects summarised here are set out in full in each product's Summary of Product Characteristics. If you are in crisis, this page is not the right place to be: ring 112 or 999, or Samaritans free on 116 123.

How this page was put together: the medicines, categories and rules described here were checked against the sources listed below rather than written from memory, and any figure we could not verify at source was left out instead of estimated. Where Irish practice differs from the rules of another country, the Irish position is the one stated on this page, and the Irish regulators named here are the HPRA for medicines, the HSE for health services, the PSI for pharmacy and the Irish Medical Council for doctors practising in Ireland. Corrections are welcome by email and are made to the page rather than argued about.