More people in the United States are on antidepressants, as a percentage of the population, than any other country in the world. And yet the drugs’ efficacy has been hotly debated.
Some believe that the short-term benefits are much more modest than widely thought, and that harms may outweigh benefits in the long run. Others believe that they work, and that they can be life-changing.
Antidepressants are a common way to treat depression. But there’s one BIG burning question on your mind…do antidepressants work?
If you’ve never taken antidepressants before, there’s a lot to think about and it’s only natural to be a bit worried.
What Do Antidepressants Do?
If you’re wondering if antidepressants actually work, the short answer is YES! Okay, now for the long answer: antidepressant medications are awesome at balancing out your brain chemistry and making your depression an easier monster to tackle. Instead of your depression looking like that massive spider from Lord of the Rings, with the help of medication, it turns into a small baby spider that you can just flick off of your arm.
Different depression meds have different functions, but we’re going to give you a general scientific overview of how antidepressants work.
There are these things in your brain called neurotransmitters. These little babies have some names that you’ve likely heard before: serotonin, dopamine and norepinephrine. These neurotransmitters increase with the help of antidepressants, helping to make you feel soooo much better!
There is growing evidence that these medicines also decrease inflammation, protect the brain, and promote new connections between brain cells. We don’t know for sure how much of a role neurotransmitters play in the mechanism of antidepressant action. All that to say, maybe it would be best to make a note that we still don’t know exactly how they work but think they play a few different roles.
But even with the knowledge that scientists and doctors have studied these medications for decades, it can be a hard pill to swallow (lol puns) when you aren’t sure if taking antidepressants is the right move for you. Here’s a list of pros and cons to help you make that decision!
1. Relieve depressive symptoms.
Basically, you won’t feel as shitty! TAKE THAT, DEPRESSION! Your depressive symptoms will decrease and, one day, you’ll have a lightbulb moment where you realize just how much better you feel.
2. Improve your motivation and increase energy.
When you’re depressed, it can be difficult to perform even the most basic self-care tasks. Shower? No thank you. Washing dishes? Absolutely not! But when you’re taking antidepressants, it can help bring back your motivation and drive! Look out, dirty dishes! Here we come!
3. Helps balance out chemicals in your brain.
The brain is a complicated thing! Antidepressants are there to help balance out the chemicals and neurotransmitters that are running around in your noggin so that you can take in the chemicals you need and start feeling like a million dollars!
4. They’re safe to take.
Antidepressants were first developed in the 1950s. So there are DECADES of science and studies that have gone into making sure that they work. Yes, there are possible side effects, but these meds aren’t inherently dangerous.
1. Some might not work for you.
Finding the right medication is like finding the right partner — you might have to try a couple of different ones before you find one that fits well into your life. And you know what? THAT’S OKAY AND COMPLETELY NORMAL! So, don’t be discouraged if one antidepressant doesn’t do the job for you right away.
2. There are side effects of antidepressants.
Every medication comes with a list of different possible side effects. Some of the common side effects for these are nausea, drowsiness, decreased sex drive, weight gain, dizziness, dry mouth and trouble sleeping. You won’t always experience all of these side effects and you might not experience any at all. Make sure that you look at the side effects of the medication your doctor or psychiatrist has prescribed you to be aware of all of the possible outcomes.
3. Coming off them can be hard.
Your doctor might recommend slowly transitioning off of your antidepressants if your depression was short-term or situational. It’s important to do this slowly and under the supervision of your doctor/psychiatrist because your body gets used to the meds and goes through withdrawals when you stop taking them.
This can leave you feeling like a pile of poop if done too quickly or if you stop them cold turkey. Always have a plan with your doctor to make the transition off of them as easy as possible.
Side note: it’s also totally normal if your doctor does NOT recommend decreasing or stopping your medication. If you have a long-term condition (like severe clinical depression, PTSD, CPTSD, or OCD for example) then you might be on medication for the rest of your life. And that’s okay.
4. They take time to work.
Doctors will usually wait an average of 4-8 weeks to see if your antidepressants are working effectively. Unfortunately, they’re not an immediate fix and do take some time to kick in. So don’t get discouraged after only a week of taking them!
There are two common types of antidepressants: Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs).
SSRIs are there to help combat an imbalance of serotonin in the brain and help reduce the serotonin reuptake function that your brain performs. This then leaves more serotonin to float around and be available in your brain — how cool is that?
SNRIs perform a similar function but reduce the reuptake of serotonin AND norepinephrine. This helps balance out the chemistry in your brain and helps you feel a heck of a lot better! SNRIs can also be used to help treat pain and anxiety.
These are the most common SSRIs and SNRIs:
- Paroxetine (Paxil, Pexeva, Brisdelle)
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Sertraline (Zoloft)
- Fluvoxamine (Luvox)
- Fluoxetine (Prozac, Sarafem)
- Levomilnacipran (Fetzima)
- Desvenlafaxine (Pristiq, Khedezla)
- Venlafaxine (Effexor XR)
- Duloxetine (Cymbalta)
Experts generally don’t know which one will work best. Also it could be well worth trying a non-drug treatment first, such as cognitive behavior therapy (CBT) or another psychotherapy.
Questions to Ask Your Doctor
Depression is one of the most complicated illnesses we have in medicine. And to get the best treatment, it’s important to get on the same page as your doctor.
You have to reach a target dose and identify your target symptoms. A lot of times, these details aren’t looked at. Then it becomes a mismatch of expectations. That’s what would be called a therapeutic failure, not a medication failure.
Here are some questions about antidepressants that you might want to bring up:
- When should I see results?
- Will I feel worse before I feel better?
- How often should I follow up?
- What are common side effects? How long do they last?
- How do I know if side effects are serious?
- What happens if the drug stops working?
- How long should I stay on an antidepressant?
- How do I know if I need to change the dose?
- What are nondrug treatments for depression?
- What is the plan for stopping the drug?
Don’t Give Up Too Early
It’s normal to want to feel better fast. But it takes time for antidepressants to work. Experts aren’t exactly sure why. One theory is that it can take days or weeks for these drugs to change the chemical pathways that lead to depression. We need more research to know for sure.
While everyone is different, it can take an average of 4-6 weeks to see big improvements. But to truly say that a medication doesn’t work, you have to give it about 8 weeks.
And don’t give up if your first antidepressant isn’t a good fit. Studies show your chances of success go up if you try more than one approach.
The important message is that medication and treatment for depression is effective. But you have to stay engaged with treatment.