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Telehealth care is available in Arizona, Florida, Illinois, Indiana, Kentucky, Michigan, Nevada, and New York. You must be in your selected state during the visit.
For general educational purposes only, not a substitute for specific medical advice. Consult with a licensed provider before implementing any adjustments to your treatment regimen.
Starting an antidepressant takes effort and hope. When weeks go by and you do not feel better, or side effects get in the way, it is easy to feel discouraged. Many people need more than one adjustment before finding a treatment that works. Here is what to consider and how to move forward safely.
Give It Enough Time
Antidepressants usually do not work right away. Some people notice changes in sleep, energy or appetite within the first couple of weeks, while improvement in mood often takes longer. It can take six to eight weeks or more at an effective dose to judge how well a medication is working.
If you have only been taking a medication for a short time, your prescriber may suggest continuing while watching for side effects, unless symptoms are getting worse.
Common Reasons a Medication Falls Short
When an antidepressant is not helping, the reason is not always the medication itself. Your prescriber may look at:
- Dose. The starting dose is sometimes too low to be effective.
- Consistency. Missed doses, or stopping and starting, can affect results.
- Side effects. Nausea, sleep changes, sexual side effects or emotional numbness can make a medication hard to stay on.
- Other conditions. Thyroid problems, anemia, sleep apnea, chronic pain and substance use can keep depression from lifting.
- The diagnosis. Some conditions, such as bipolar disorder, can look like depression but need a different treatment approach.
- Life circumstances. Ongoing stress, grief or isolation may need support beyond medication.
Next Steps to Discuss With Your Prescriber
Depending on your situation, options may include:
- Adjusting the dose of your current medication
- Switching to a different medication, often with a planned transition
- Adding a second medication to boost the effect of the first
- Adding talk therapy, which can work well together with medication
- Treating sleep problems or other conditions that affect mood
- Referral to a psychiatric specialist when several treatments have not helped
Do Not Stop Suddenly
Stopping an antidepressant abruptly can cause discontinuation symptoms such as dizziness, flu-like feelings, irritability, trouble sleeping and brief electric shock sensations. It can also bring symptoms back. Talk with your prescriber before stopping or changing a dose so you can taper safely if needed.
Where GeneSight® Testing May Fit
GeneSight® Testing is a pharmacogenomic test that uses a cheek swab to look at genes that can affect how your body processes certain medications used for depression, anxiety and other conditions. It may add useful information when depression has not responded to one or more medications or when side effects keep getting in the way.
The results are one input, not an answer. They do not diagnose depression, and they cannot guarantee that a particular medication will work. Your prescriber reviews them together with your symptoms, history and past treatment response. The test is billed by the laboratory, separately from your visit. Learn more on our GeneSight® Testing page.
When to Get Help Right Away
Contact your prescriber promptly if your mood is getting worse, you feel agitated or restless, or you notice unusually high energy with little need for sleep. If you have thoughts of suicide or self-harm, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911 in an emergency.
The Short Answer
An antidepressant that is not working is a reason to revisit the plan, not a reason to give up. With time, the right dose and a careful look at what else is going on, most people can find an approach that helps.
Learn more on our online mental health care page.
Get Support
Wade’s Care First provides telehealth care in Arizona, Florida, Illinois, Indiana, Kentucky, Michigan, Nevada and New York, with same-day appointments when available. Visits are with Charles Wade, FNP-BC, a board-certified family nurse practitioner.
We accept many major insurance plans, including Original Medicare (Indiana only), Medicaid (Indiana and Illinois only), UnitedHealthcare, Aetna, Humana and Cigna. Plan participation varies by state, and self-pay visits are available.
If your current treatment is not helping the way you hoped, a follow-up visit to review your options is a good next step.
Book at wadescarefirst.com.
Answers connected to this topic.
How long does it take for an antidepressant to help?
Some symptoms may begin to improve within a few weeks, but full response can take longer. Timing varies by medication and individual, and follow-up is important.
Does everyone need genetic testing before starting an antidepressant?
No. Many people can start treatment without pharmacogenomic testing. We consider the test selectively based on your history and treatment decisions.
What should I do if a mental health medication causes side effects?
Contact the practice for guidance. Do not stop a prescribed medicine abruptly without advice unless urgent symptoms require emergency treatment.
Further reading: nimh.nih.gov · medlineplus.gov · nhs.uk.
