by Sergio Silva, M.D.

Created on: August 20, 2009

Why Your Antidepressant May Not Be Working

Modern antidepressant medication trials are highly effective across the board, but many patients, particularly treatment-nave individuals who are new to taking psychotropic medications, often report that their medication isn't working as well or as quickly as they had anticipated. This article covers the most common mistakes and misconceptions patients make when first taking prescription psychotropic medication for purposes of improving their mood. Once these common problems and pitfalls have been fixed or ruled out, there are indeed various options you can explore with your prescribing physician to alter the prescribed treatment regimen and get a better response.

The medicine has not been taken for a long enough period of time. This is probably the most common reason a medication doesn't seem to be working after starting taking it, and it is simply a matter of expectation: early on, it simply hasn't had enough time to work. Although in a minority of cases a person will begin feeling better within a few days (I've seen this with the dual-acting agent Effexor a number of times, especially in individuals with moderate-to-severe symptoms that are largely due to endogenous, or physical, depression), it is more standard for a person to appreciate only mild side effects initially, for as long as two or three weeks, before gradual improvements begin to be noticed. In fact, many times just as most of the side effects are beginning to disappear, the therapeutic effect begins kicking in. It is definitely worth sticking it out until this occurs!

Even in those individuals who begin to feel better right away, the full effect of an antidepressant medication can easily take 2-4 weeks or longer to manifest. Considering that many times a starting dose will have to be optimized by increasing it a few times, depending in part on how the person is tolerating and adapting to the side effects, it could be 6-12 weeks or longer before just the right dose has been taken for long enough for a medication's full benefit to become apparent. So patience is key. That said, in the vast majority of cases, you should begin to see noticeable improvement in your symptoms well within the first month.

What can you do in the meantime? One thing your doctor can do is to prescribe other, short-term medications designed to address certain target symptoms while you are waiting to feel better. For example, if insomnia is a prominent

• 1
• 2
• 3
• 4
• 5
• Next Page >>