You've been going to therapy, taking your antidepressants as directed, and following all of your doctor's advice. But you still don't feel like your old self.
What's taking so long? It can be frustrating to wait for your depression treatment to start to work.
Be patient, but not passive, when managing your depression, experts tell WebMD. This five-step action plan can help you get the most from your depression treatment:
Antidepressants: Know Your Options
There are many drugs to choose from to treat depression. The initial choice is usually based on which symptoms are most troublesome and potential side effects, says Bryan Bruno, MD. He is the acting chairman of psychiatry at Lenox Hill Hospital, New York City. For example, your doctor may opt for a medication that has sedative effects if your depression is interfering with your ability to get good sleep.
The most popular types of antidepressants are called selective serotonin reuptake inhibitors (SSRIs). These include:
- Celexa (citalopram)
- Lexapro (escitalopram)
- Paxil (paroxetine)
- Prozac (fluoxetine)
- Zoloft (sertraline)
These drugs work by increasing the availability of serotonin, a brain chemical known to affect moods. If one drug in this class does not work for you or has unacceptable side effects, others may work. SSRI side effects may include headache, nausea, sleeplessness or drowsiness, agitation, and decreased sexual desire.
Other types of antidepressants work on both serotonin and another brain chemical called norepinephrine. These are known as serotonin and norepinephrine reuptake inhibitors (SNRIs). They include:
- Cymbalta (duloxetine)
- Effexor (venlafaxine)
- Pristiq (desvenlafaxine)
Older antidepressants include tricyclics, tetracyclics, and monoamine oxidase inhibitors (MAOIs). These tend to have more side effects than some of the newer depression drugs, but are still used.
Action Plan Step #1: Talk About Your Treatment Options
Discuss with your doctor all the available options, their pros and cons, and which ones can safely be used together.
Make a list of questions that you have for your doctor. You may want to ask your doctor the following questions about your medication options:
- How long will it take for the medication to work?
- When should I take the medication?
- Should I take the medication with food?
- What are the side effects?
- What can I do to manage side effects?
Action Plan Step #2: Give Your Medication Time to Work
Antidepressant medications do not work overnight. It can take several weeks for the drug or drugs to start affecting your mood. Some depression drugs may start to work sooner than others, but in general it takes time for certain brain chemicals involved in mood to rise. Select depression medications are started at lower doses to see if there are any unacceptable side effects. They are then slowly increased to get to a therapeutic dose if no side effects occur.
Be realistic about when you can expect to start feeling better. But "stay in close contact with your doctor when starting or changing your depression medications," Bruno says.
It's also important to know when to call in a psychiatrist or other mental health specialist. "Most antidepressants are prescribed by primary care doctors today," he says. "If you haven't gotten any better after a reasonable drug trial, seek out a referral to a psychiatrist." Some trial and error may also be involved in drug choice and dosing issues.