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Unhappy With Your Antidepressant?

Maybe it’s time for a change.
By Arthur Allen
WebMD Feature

If you’ve ever taken an antidepressant, you know that the first several days or even weeks can be rough. Antidepressants take time to work and some can cause unpleasant side effects like dizziness, nausea, sweaty palms, and diarrhea. When you put all that together, you may start to doubt the value of a medication that takes a month to make you feel better.

Chances are good that you will feel better, eventually. If your response to medication is inadequate after 6-8 weeks, talk with your doctor about modifying your treatment. If after six weeks you are not noticing a change in mood on an antidepressant, it may not be right for you. First, make sure you are taking the drug as directed. Then talk with the doctor about how you feel. The doctor can suggest a variety of combined and alternative treatments, as well as various types of talk therapy that can help improve your depression.

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The important thing is to get consistent care from a physician or therapist who is attentive to your responses, says psychiatrist Myrna Weissman, PhD, a professor of epidemiology and psychiatry at Columbia University.

Allow Time to Find the Right Antidepressant

Antidepressants work. So does cognitive therapy. But finding the right antidepressant and the right combination of treatments takes time.

In one large study of the effectiveness of antidepressants, only about 30% of the patients became symptom free within four months of taking the first antidepressant prescribed, says Bradley Gaynes, MD, MPH, an associate professor of psychiatry at the University of North Carolina.

Gaynes says that another 20% of people gained relief after switching antidepressants or adding cognitive therapy or another medication to their treatment. And by the time the remaining people had switched antidepressants two more times, 70% no longer described themselves as depressed.

Talk to a Depression Specialist

The important thing, Gaynes tells WebMD, is not to give up too fast. Often, he says, patients get their first prescription for an antidepressant from their regular doctor. But many require a psychiatrist to sort out all the options. This is especially true if you feel symptoms of panic or anxiety that either start or continue while you’re taking an antidepressant.

One key to knowing whether you are taking the right drug, Gaynes says, is to make sure you’re getting a strong enough dose.

“Under dosing,” he says, “may be a bigger problem than which drug you choose,” says Gaines. “Primary care physicians are more likely to under dose out of caution or lack of familiarity with a drug.” A psychiatrist can look at the drug you’re taking and let you know whether the dose you’ve been prescribed is adequate for treating your depression.

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