It takes from two to six weeks for an antidepressant to begin to work. You may feel worse before you feel better because side effects can occur almost immediately, whereas therapeutic benefits appear later. The good news is that most side effects dissipate within days or weeks.
Antidepressants are not habit-forming and are not drugs of abuse.
Do not despair if the first medication does not work. Finding the appropriate medication(s) and dosages may take time. The good news is that many different antidepressants are available.
The most frequent reason for an antidepressant “failure” is that the dose was too low and the duration of treatment too short.
Feeling better is not a good reason for discontinuing or reducing your medications. Individuals often are tempted to stop medication too soon, risking relapse or recurrence. For individuals with bipolar disorder or recurrent major depression, medication may have to become part of everyday life to avoid return of disabling symptoms.
You should never mix medications of any kindprescribed, over-the counter, herbs, or borrowedwithout consulting a doctor. Some drugs, like alcohol, reduce the effectiveness of antidepressants and should be avoided. This includes wine, beer and hard liquor.
Some drugs, which are usually safe when taken alone, can cause severe and dangerous side effects if taken with other drugs. Always tell dentists, pharmacists and other medical specialists that you are taking antidepressants.
If you have been prescribed an MAOI (such as Parnate or Nardil), you will have to avoid certain foods and over-the-counter medications. Be sure to get a complete list of disallowed foods and medications from your doctor and always carry it with you.
Antianxiety drugs, such as diazepam (Valium) or alprazolam (Xanax), are not antidepressants. They are sometimes prescribed along with antidepressant therapy, but should not be taken alone for a depressive disorder.
Scientific studies suggest that patients with three or more episodes of depression or two severe episodes may need to be maintained on antidepressants indefinitely. The maintenance dose should be the same as the dose required to achieve an initial therapeutic response.
Antidepressants work best in most individuals when prescribed alongside a course of psychotherapy. People taking both medication and engaging in psychotherapy generally take less time to feel better and maintain their gains longer than those taking antidepressant medications alone.
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Michael Herkov, Ph.D., and Wayne Goodman, M.D. also contributed to this article.