Theses can be mainly understood in terms of the effects of the drug on other receptor systems apart from 5-HT, dopamine and noradrenaline. The antihistamine effects give rise to sedation and psychomotor impairment. The antihistamine action also potentiates the sedative effects of alcohol. The anticholinergic gives dry mouth, constipation, urinary retention in the elderly, glaucoma in predisposed individuals and memory problems. Alpha-blocking effects can cause postural hypotension and a quinidine-like action gives rise to caradiac conduction defects.
Stimulation of noradrenergic systems can give rise to cardiac arrhythmias. Beyond that are idiosyncratic reactions such as skin rashes or hepatotoxicity, which are common to almost all medications. In some rare instances antidepressants may precipitate episodes of hypomania. Despite the daunting list of potential side effects, they are for the most part mild, wane after the first few days of treatment, and are generally tolerable, especially if the patient is warned about them and the dose increased gradually.
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