By Tannia Salazar, APRN | Rooted in Serenity Behavioral Health 🌿

If you’ve been prescribed an antidepressant—or are thinking about asking for one—you may have heard the term “atypical antidepressant.” The name can sound intimidating or experimental, but really it just means these medications don’t fit neatly into the more common categories like SSRIs or SNRIs.

In this post, I’ll explain what atypical antidepressants are, how they work, what side effects to expect, and how they might play a role in your care.

What Does “Atypical” Mean?

“Atypical” simply means these medications don’t belong to the largest, more familiar groups. They work differently in the brain, often by targeting neurotransmitters beyond serotonin—such as dopamine or norepinephrine.

Because depression and anxiety look different for everyone, having more than one type of antidepressant available gives us more flexibility to find what works for you.

What Conditions Do Atypical Antidepressants Help With?

Depending on the medication, they may be used for:

Major depressive disorder (MDD)
Anxiety disorders
Sleep problems related to depression or anxiety
Appetite and weight changes connected to mood
Smoking cessation (Bupropion)
Cognitive “fog” or lack of motivation

Common Atypical Antidepressants

Here are a few medications you may hear about:

Bupropion (Wellbutrin) – Often chosen when energy, focus, or motivation are low. May also help reduce cravings for nicotine.
Mirtazapine (Remeron) – Helpful when poor sleep and low appetite are major concerns. Can improve rest and support healthy weight gain when needed.
Trazodone – Technically an antidepressant, but most often used in lower doses to help with sleep.
Vilazodone (Viibryd) & Vortioxetine (Trintellix) – Newer medications that affect serotonin in multiple ways, sometimes improving both mood and cognitive clarity.

Each one works a little differently, which is why your provider will match the choice to your unique symptoms and history.

How Long Do They Take to Work?

Much like SSRIs, atypical antidepressants don’t bring instant relief. Most people can expect:

1–2 weeks for small improvements (like better sleep or appetite)
6–8 weeks for full effects on mood, concentration, or energy
Up to 12 weeks in some cases, depending on your body’s response

Patience is important. Adjustments are common, and your provider will guide you through this process.

Common Side Effects

Most side effects happen early—within the first 1–2 weeks—and often fade with time.

Here’s a quick guide:

Side Effect	How It Might Feel	What to Expect / When to Reach Out
Nausea or stomach upset	Queasiness, especially in the morning or on an empty stomach	Often fades within 1–2 weeks; take with food. Call if severe or persistent.
Drowsiness or fatigue	Feeling unusually tired or groggy (more common with mirtazapine, trazodone)	Expected early on; often improves. Reach out if it disrupts daily functioning.
Restlessness or jitteriness	Feeling “amped up” or restless, especially with bupropion	May settle over time. Call if it worsens anxiety or prevents sleep.
Appetite changes	Mirtazapine may increase appetite; bupropion may decrease it	Can be useful depending on needs. Reach out if weight change feels extreme.
Sleep changes	Improved sleep (with mirtazapine/trazodone) or difficulty falling asleep	Often balances with dose timing. Contact provider if insomnia worsens.
Headache or dizziness	Mild headache or lightheadedness, especially when standing quickly	Usually temporary. Seek help if ongoing, severe, or sudden.

What Atypical Antidepressants Don’t Do

They don’t erase your emotions.
They don’t change your personality.
They don’t “cure everything overnight.”

What they can do is bring your brain to a steadier place—so you can engage more fully in therapy, relationships, and daily life.

What to Expect If You Start One With Me

At Rooted in Serenity Behavioral Health, I’ll guide you step by step. We’ll cover:

Your goals, symptoms, and full medical history
Which medication (if any) might fit best
How to tell the difference between normal adjustments and concerning side effects
What to expect in the first few weeks
When and how to adjust the plan if needed

You’ll never be left wondering alone. Every question is welcome, and every experience you share matters.

Final Thoughts

Atypical antidepressants aren’t “last resorts.” They’re simply another path—and for many, the right path—toward steadier mood, better sleep, and renewed motivation.

If you’re struggling with depression, anxiety, or sleep changes, you deserve to know all your options.