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Alternatives - Antidepressants

There are many alternatives to antidepressants for depression and other mental health conditions.

Talking therapies

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is a type of talking therapy. A combination of CBT and antidepressants is common for moderate to severe depression.

If you're unable or unwilling to take antidepressants, you have the option of CBT on its own.

Cognitive behavioural therapy (CBT) helps you manage problems by thinking more positively. It frees you from unhelpful patterns of behaviour.

Some CBT therapists may also add a mindfulness or compassionate module.

Mindfulness means paying attention in a particular non-judgmental way in the present moment.

This can make it easier for you to tackle sometimes overly-critical self-thoughts. This will help you to engage better with the people by improving your self-esteem and self-confidence.

Read more about mindfulness

Online CBT

Computerised CBT is a form of CBT. It works through a computer screen, rather than face-to-face with a therapist.

Ask your GP for more information.

Self-help therapies

Interpersonal therapy (IPT)

Interpersonal therapy (IPT) focuses on your relationships with other people. It also focuses on problems you may be having in your relationships. For example, difficulties with communication or coping with bereavement.


Counselling helps you think about the problems you're experiencing in your life. It helps you to find new ways of dealing with them. Counsellors support you in finding solutions to problems but don't tell you what to do.

You talk in confidence to a counsellor, who supports you and offers practical advice.

Counselling is ideal for people who are healthy but need help coping with a current crisis.

For example:

  • anger
  • relationship issues
  • bereavement
  • redundancy
  • infertility
  • the onset of a serious illness


Regular exercise may be a more effective treatment for mild depression than antidepressants.

Exercise helps boost levels of chemicals called serotonin and dopamine in the brain. These can lift your mood.

Exercising on a regular basis can boost self-esteem and confidence. This can help to relieve symptoms of depression.

Your GP may refer you to a fitness trainer for an exercise scheme. Or you can read about starting exercise.

Exercise and your mental health

Self-help groups

Talking through your feelings can be helpful. Talk to a friend or relative, or ask your GP to suggest a local self-help group. There are also chat rooms on the internet that offer support.


You may have tried several different antidepressants and seen no improvement. If so, your doctor may offer you a medication called lithium. You will get this with your current treatment.

There are 2 types of lithium:

  • lithium carbonate
  • lithium citrate

Both are usually effective. If you're taking one that works for you, it's best not to change.

If the level of lithium in your blood becomes too high, it can become toxic. So, you'll need blood tests every three months to check your lithium levels while you're taking it.

You'll also need to avoid eating a low-salt diet because this can also cause the lithium to become toxic. Ask your GP for advice about your diet.

Side effects of lithium include:

  • dry mouth
  • a metallic taste in your mouth
  • some mild shaking of your hands
  • diarrhoea

These side effects usually pass with time once your body gets used to the medication.

Electric shock treatment

Brain stimulation can be used to treat severe depression. It is used when the depression has not responded to other treatments.

There are a number of types of brain stimulation. Electroconvulsive therapy (ECT) is the most common.

During ECT an electric current passes to the brain through electrodes placed on the head.

ECT is always carried out under a general anaesthetic in a hospital by a specialist doctor.

Content supplied by the NHS and adapted for Ireland by the HSE

Page last reviewed: 20 August 2022
Next review due: 20 August 2025

This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.