Ask the Doctor: Antidepressants Not Working?

I don’t think my antidepressants are working. What should I do?

It is important to take an antidepressant for a long enough time, perhaps a month, before deciding whether it works. In general, all antidepressants have a similar rate of effectiveness but differ in the type and degree of side effects. This is true in a statistical sense, but research and clinical experience suggest that individuals may benefit from one antidepressant but not another. Increasing the dose may be the first thing to try, and if that fails it may be useful to switch to another antidepressant. Another option is to add a second medication that may augment the therapeutic effect of the antidepressant.

Unfortunately, a significant minority of patients do not benefit, or benefit only partially, from antidepressants. Sometimes this may be because the diagnosis is incorrect, and the patient has some problem other than a clinical depression. However, even when the diagnosis is correct, the medication may not work Psychotherapy is often as effective, or sometimes more effective, than medication. The depressed patient for whom medication is not the answer should be evaluated for the type of psychotherapy that may be the most appropriate for him or her.

Posted in Ask the Doctor Q&A.