Am Fam Physician. 2023;107(2):online
Related article: Pharmacologic Treatment of Depression
How do medicines help with depression?
They are thought to work by changing levels of natural chemicals in your brain called neurotransmitters. Neurotransmitters help cells in your brain communicate with each other, and this can change the way you feel. These medicines can help people with mild or moderate depression, but they're most effective in people with more serious depression. These medicines work best if you take them every day. They don't work as well if you take them only on days when you feel bad.
How long do they take to work?
Some people start feeling better after just a couple of weeks. Others don't feel better for up to eight weeks. Keep in mind that the changes might be small at first. For example, you may notice that your appetite is coming back or that you're sleeping better, even though you still feel the same. Be patient and follow up closely with your doctor.
What if I don't notice a difference after eight weeks?
Don't give up. Talk to your doctor about your options. You might need a higher dose of your medicine or a different medicine. Don't increase your dose or stop your medicine without talking to your doctor first.
Are there side effects?
Side effects are usually mild, such as headache, upset stomach, or diarrhea. Some people may have drowsiness, whereas others may have trouble sleeping. You can adjust the time of day you take your medicine if you have these side effects. Sometimes these effects go away after about a week as your body gets used to the medicine. Some medicines are less likely to cause side effects than others. Talk to your doctor if they don't go away. You may need to try a different medicine.
Medicines for depression might raise your risk of suicide during the first three months of treatment. This is more likely to happen in people younger than 25 years. Tell your family and close friends about this. Ask them for help if they notice anything that concerns them. If you have any sudden changes in your mood, see your doctor.
Are these medicines addictive?
They aren't addictive, but you may have unpleasant side effects if you suddenly stop taking them. You might have flulike symptoms, trouble sleeping, nausea, and balance problems. You might have a “pins and needles” feeling, or feel keyed up or jittery. Talk to your doctor before you stop taking the medicine. Often, your doctor will slowly lower your dose until you are no longer taking your medicine. They also may slowly stop one medicine while slowly starting another.
Is there anything else that can help with my depression?
Yes. Talk to your doctor about counseling, especially a type called cognitive behavior therapy (CBT). Depressed feelings are often caused or made worse by how you think about yourself and the world, and by how you react to things. CBT helps you change these thoughts and behaviors in ways that can help you feel better.
Where can I get more information?
Your doctor
National Institute of Mental Health
National Library of Medicine
