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Do Antidepressants Work?

Whether you experience a mental health diagnosis alone or along with a substance use disorder, asking for help can be difficult enough. If you’ve been prescribed an antidepressant to help manage your mental health, you may already know that it often takes some time for antidepressant medications to work. While this process can be incredibly frustrating, it’s an unfortunate reality of most people’s mental health treatment. Being informed about how long it takes antidepressants to work can make your journey to better health easier.

Why Does It Take Time for Antidepressants to Work?

Some of the most commonly prescribed antidepressants are SSRIs, or selective serotonin reuptake inhibitors. Most experts believe that SSRIs work by blocking the serotonin transporter in the brain. The transporter carries serotonin molecules into brain cells.

Serotonin is a neurotransmitter that helps to regulate anxiety and reduce depression. However, in order to have any effect on the brain at all, it needs to be working outside of the brain’s cells. When the transporter is blocked, there’s more serotonin moving freely in the brain, so you should feel less depressed and anxious.

When you start taking an SSRI, the drug starts blocking the serotonin transporters right away. However, it can take between four and six weeks to see the full benefit of an SSRI.

Researchers don’t know exactly why it takes so long for SSRIs to work, but recent research suggests that the drugs interfere with G proteins, which are the signaling molecules needed for a person to experience the medication’s full effects. This interference means that it takes a considerably long time for you to feel the full benefit of SSRI treatment.

Of course, the time it takes for you to respond to SSRIs and other antidepressants also depends on your individual physiology. Liver health, age, sex and pregnancy can all influence how long it takes to start seeing results. Even having good or poor nutrition can have an effect.

How Long Does It Take to See Improvement?

Generally, you won’t feel the full benefit of an SSRI at once; the improvement is gradual. While it isn’t always the case, some people start to feel some relief from symptoms of depression as soon as two weeks after starting treatment.

However, if you start taking an antidepressant and don’t notice any improvement within the first two weeks, don’t be alarmed. Plenty of people notice no effect whatsoever on their mood at first.

Starting with a higher dose of an antidepressant often means that you’ll start to notice symptom relief sooner. However, most doctors prefer to start with a smaller dose and gradually increase it.

How Long Does It Take to Get the Full Effect?

Some studies have shown that it can take as long as 8 to 12 weeks to get the full benefit of an SSRI. However, most doctors will look for some improvement after four to six weeks. If you have no improvement whatsoever at that point, it may be a sign that a given antidepressant isn’t the right medication for you. Sometimes, a doctor may change your antidepressant medication or add another if you see no improvement by six weeks.

Using alcohol or other drugs can delay or even prevent the full benefits of antidepressant treatment. If you have a mental health diagnosis along with a substance use disorder, our inpatient treatment program at Granite Recovery can help you recover. As an inpatient, you’ll receive individualized care from doctors who will monitor your progression on antidepressants and help you change medications if necessary. Our staff will also help you develop healthier coping skills and learn to live a life free from drugs or alcohol.

How Long Should You Take Antidepressants?

There’s no single recommended course of treatment when it comes to antidepressant therapy. Some people only need medication for a brief period of time, but others may need to take an SSRI for the rest of their lives.

In many cases, doctors recommend that you take an antidepressant for six months to one year, even after your symptoms subside. With this treatment timeline, you’ll be less likely to experience a relapse or return of depressive symptoms when treatment ends. It’s important to not end treatment early as soon as your mood begins to lift; this may lead to a return of depressive symptoms.

Some research suggests that it’s best to take an antidepressant for at least 36 months, and some experts recommend continuing to take antidepressants for at least two years if you have experienced recurrent depression before. Generally speaking, if you have a longer and more difficult history with depression, your doctor will recommend staying on an antidepressant for a longer time after your symptoms go into remission.

In some cases, your doctor may recommend indefinite treatment. This is more common in patients who have additional psychiatric disorders and for those with chronic major depression. When your depression is very severe, the potential benefits of long-term treatment often outweigh the potential risks. Ultimately, there are several different variables at play when it comes to deciding the length of your antidepressant medication, so it’s very important to discuss length of treatment with your doctor.

How Can You Improve Medication Effectiveness?

When you’re suffering considerably from mental health symptoms, you likely want to do all you can to make sure you’re getting the most out of your medication. While you shouldn’t attempt any of these strategies without the help of a doctor, there are a few things you can do to increase your medication’s effectiveness.

One common strategy is combining two different antidepressants. If you get some relief with one antidepressant but are still experiencing symptoms, your doctor may add in another medication. That medication is usually another antidepressant or an atypical antipsychotic.

Using more than one medication to treat depression is called combination therapy, and it’s more common than you might think. Combination therapy tends to have higher success rates than just using one medication, so it’s a logical go-to if therapy with one antidepressant isn’t working.

Another strategy that may sound obvious is increasing the dose. Most doctors will choose to start you out on a relatively low dose of an antidepressant. The low dose gives your body time to adjust, and it also can reduce your risk of developing serious side effects.

However, this isn’t a strategy that can be used indefinitely. Most doctors have observed that after a certain point, increasing doses of an antidepressant will increase side effects without having a noticeable effect on your symptoms.

Sometimes, you and your doctor may believe that a given medication is not helping you at all. In this case, your doctor may discontinue this medication and prescribe another.

Starting or continuing talk therapy is also likely to increase the effectiveness of an antidepressant. Studies have consistently shown that these drugs work best when used in conjunction with cognitive behavioral therapy or a similar type of therapy.

Can Antidepressants Suddenly Stop Working?

Unfortunately, the answer to this question is yes. Some people develop antidepressant tolerance, which is when a given antidepressant stops having the effect it once did. Antidepressant tolerance is a phenomenon that happens in some people but not in others, and doctors aren’t sure exactly why it happens.

This phenomenon is more common than you might think; some research suggests that up to 33% of people on antidepressants may experience a return of symptoms in what’s called breakthrough depression.

If this happens to you, don’t give up hope. Breakthrough depression doesn’t mean that no antidepressant will work for you; it just means that your medication regimen may need an adjustment. Be sure to tell your doctor if you notice that your depressive symptoms are starting to recur.

What Other Options Are There for Severe Depression?

If your depression is severe or doesn’t seem to respond to traditional treatment methods, your doctor might recommend alternative treatment types. One of these is transcranial magnetic stimulation. This therapy involves using magnetic fields to target parts of the brain that are involved in depression. It’s become more popular because it’s non-invasive and has fewer side effects than electroconvulsive therapy.

Electroconvulsive therapy is an older treatment that is still sometimes used when depression doesn’t respond to standard treatment. It involves causing a brief seizure, and it’s useful in cases where it might be too dangerous to wait for a traditional antidepressant to work.

If you need rapid relief from extremely severe depression, esketamine may be a helpful treatment. This drug is usually administered via an IV or a nasal spray, and it can start to relieve symptoms of depression in a few hours. Esketamine does this by interacting with glutamate, a neurotransmitter that stimulates other neurotransmitters like serotonin and norepinephrine. Unlike SSRIs, which can take weeks to reach their full effects, esketamine starts working almost immediately.

It’s important to note that esketamine is not recommended as a standalone treatment for depression. It’s designed to be used along with an antidepressant medication. However, if your doctor sees that your mood isn’t improving with antidepressants alone, they may recommend adding on esketamine treatment. It’s a newer treatment and isn’t widely used yet, but it shows considerable promise for the future.

What If You Also Have a Substance Use Disorder?

If you also suffer from a substance use disorder, dual diagnosis treatment may help. This type of treatment involves treating both your substance use disorder and your mental health diagnosis at the same time. If you have a dual diagnosis, you aren’t alone. In 2017, 8.5 million American adults had both a substance use disorder and a mental health diagnosis. In some cases, a substance use disorder develops largely because a patient is trying to self-medicate a diagnosed or undiagnosed mental health condition.

At Granite Recovery Centers, we offer dual diagnosis treatment. The treatment may involve different types of therapy and medication to manage both conditions. Since a substance use disorder can make a mental health diagnosis worse and vice versa, it’s important to receive care from doctors and counselors who are familiar with both. Your treatment team at Granite Recovery Centers is committed to your holistic recovery, and they will be with you every step of the way.

If you’re ready to take the first steps to improve your life, Granite Recovery Centers is here to help. With our residential and outpatient treatment programs, you’ll find a treatment solution that will help you free yourself from the grip of substance use disorders and mental health issues. Give us a call today.