In addition to a worsening of depression symptoms, a patient who experiences any of the following side effects needs to report the problem to medical personnel: abnormal heart rate, chest pain, abrupt numbness or headaches, confusion, impaired vision or speech, hallucinations, tremors, restless muscle movements, skin rashes, abnormal bruising or bleeding, severe thirst, or a decrease in urination. Some other side effects that are milder are dry mouth, nausea, constipation, difficulty concentrating, nightmares, dizziness, diarrhea, vomiting, loss of appetite, decreased sex drive, or swollen breasts.