In a “perfect drug” scenario, medications would zero in on their intended target systems producing only desired, therapeutic effects, then metabolize and leave the body. Unfortunately, it’s not that simple, as medications act in a scatter-shot sort of way by finding unintended receptor targets – producing adverse, unwanted and undesirable effects as well.
You must be honest with clients about medication side effects and this issue should be discussed up front, preferably before medication initiation. Point out that although practically every drug – prescription and over-the-counter – has side effects, many of them are short-lived and “run their course” as the body gradually adapts to the new substance. Then discuss them, one-by-one, focusing only on those most frequently reported. It is not necessary to mention every side effect listed in the drug’s package insert or the PDR. More is not more here, keep it simple.
You might also want to suggest ways for combating side certain side effects. For example, medications that are linked to the adverse effects of anxiety and insomnia are best taken in the morning. More sedating medications should be taken at bedtime; those associated with nausea should be taken with food.
With antidepressants in particular, I believe it makes sense for a client to make their own initial drug choice based on acceptable side effects. When discussing various antidepressant options, I’ll then ask them what side effects they willing to put up with or tolerate. This strategy empowers them to take ownership of their treatment thereby enhancing compliance.