Antidepressants: 7 Best Questions to Ask Your Doctor
Antidepressants are widely used to treat depression, but the effects are individual. Know how these drugs work, how effective they are and what to expect before you fill your prescription.
Antidepressant use is widespread, yet many questions remain about these drugs. How do they work? Are they effective for everyone? And what are the side effects?
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Behavioral health specialist Ketan Deoras, MD, says antidepressants ease depression by adjusting your brain’s chemistry, but they produce individual responses, too.
“It’s simplistic to say it’s a matter of chemical imbalance,” he says. “A patient’s temperament, environmental stressors, and genetic traits and vulnerabilities all can play a role, as well.”
Dr. Deoras tells patients to consider antidepressant treatment if their mood interferes with work, family or socializing for more than two weeks. You might not notice the problem, but family or friends may mention it.
Medication could be particularly necessary if outbursts lead to legal troubles, he says.
Typically, antidepressants help balance the levels of neurotransmitters, which are chemicals responsible for communication between neurons in the brain. Higher levels of these chemicals, including serotonin, dopamine and norepinephrine, typically correspond with lower levels of depression.
How long the drugs stay in your body varies, as well. Some last 36 hours; others last several days.
Each patient responds to antidepressants differently, Dr. Deoras says. He advises patients to allow four to six weeks for the medication to build up to provide the most benefit.
Typically, if you are experiencing benefits and tolerating side effects, Dr. Deoras recommends that patients remain on antidepressant medication a minimum of six months.
Antidepressant drug side effects can also vary greatly, Dr. Deoras says.
The most common physical effects are headaches, insomnia and gastrointestinal problems, such as nausea and diarrhea.
For mood, these drugs can increase depression and anxiety. Once your body adjusts, the side effects should subside, he says. But, if not, talk to your doctor about discontinuing use.
In 2004, the Food & Drug Administration issued a black box label warning for suicidal ideation among 18- to 24-year-olds for common antidepressant medications. This is the FDA’s strictest warning for labeling prescription drugs.
The effect of suicidal thoughts is most common with a certain type of antidepressant — selective serotonin reuptake inhibitors (SSRIs). It occurs in about 4 percent of people who take these drugs. But, the benefit largely outweighs the risk, Dr. Deoras says.
“The real risk of suicide is leaving depression untreated,” he says. “That’s more worrisome than using medications to treat it.”
Your doctor should evaluate your condition during treatment to make sure that you continue to improve. It’s important to avoid extra stress in your life if you taper your medication use.
Remember, you may feel better because the antidepressant is working.
If you choose to come off the medication, do it slowly under your doctor’s supervision, Dr. Deoras says. Some drugs cause intense withdrawal symptoms that sometimes ramp up depression and anxiety again.