What to Do When Your Antidepressant Stops Working

50%-60% of individuals using antidepressants find relief from the first one they try. Unfortunately, some may not get complete relief from their depression symptoms, and others have no response at all.

Read on to learn what to do when antidepressants don’t work for you anymore. Understand what to expect, review questions to ask your healthcare provider, and learn several ways to adjust your treatment plan and explore different therapies.

Understand What to Expect from Antidepressants

When it comes to antidepressants, misconceptions are common, and can create confusion about depression remission. For this reason, when considering antidepressants, you should begin by setting realistic expectations regarding symptom relief from your depression.

What to do when antidepressants don't work

How Do Antidepressants Work?

Antidepressants are not instant fixes, and they do not create a feeling of euphoria shortly after taking them. In fact, it may take several weeks to feel the full, mood-stabilizing impact. You may also experience short-lived side effects before you feel relief, including a local “dip” in your mood, but that does not indicate how effective an antidepressant may be after it is given adequate time to take effect.

What if My First Type of Medication Does Not Help?

It may take more than one attempt to find an effective antidepressant for you. While 36.8% of individuals get relief from the first antidepressant they try, another 30.6% only see improvement after trying a second type of antidepressant.

What Does It Mean to Be in Depression Remission?

Being in remission from depression means you may still have bad days and problems to work through, as this is still normal for those without depression. However, once in remission, you will be better equipped to process, cope, and manage the challenges of life, without becoming incapacitated by them.

Could I Become Depressed Again After Treatment?

Depression can reoccur throughout an individual’s lifetime. 50% of those who have experienced one depressive episode will go through another once during their lifetime, and 80% of those who have contended with two episodes are likely to experience additional episodes in the future. Understanding how to respond to difficult life situations can help you avoid or shorten future depressive episodes.

Talk to Your Healthcare Provider

Some individuals take longer to respond to antidepressants or may not get complete relief. Before you see signs your antidepressant is not working, ask your healthcare provider about your medication and anything that may impact your response.

Take Your Medication Correctly

To ensure you get the most relief possible from your antidepressant, be sure you understand how to take it correctly. Ask your doctor the following questions:

  • What do I do if I accidentally miss a dose or take an extra one?
  • Can I take it at the same time as other medications?
  • Are there medications or substances I should avoid while taking this antidepressant?

Signs your antidepressant isn't working

Rule Out Other Conditions

Depressive symptoms also overlap with other physical and mental health conditions, and a misdiagnosis is also a possibility. Ask your doctor:

  • Could other psychological or physical health disorders make my antidepressant less effective?
  • Could other mental or physical health disorders be the true cause of my depression?

Ask About Physical Changes

Changes in your physical depression symptoms may be your first clue that your antidepressant is starting to work, often within the first two weeks. Find out:

  • What changes might I see with my sleep?
  • What changes might I see with my appetite?
  • How soon will I get my energy back?

Give It More Time

Antidepressant response varies among individuals, and some medications may need more time to take full effect. Make sure you have a sound estimate about:

  • How soon will I start feeling better?
  • What is the longest I should wait to see my symptoms improve?
  • How long could it take to get the most relief possible from my antidepressant?

Reevaluate or Change Medication

After taking an antidepressant for several weeks, you and your provider may be ready to adjust your medication plan.

Adjusting your dosage should only be done in consultation with a licensed, experienced professional.

  • Adjusting Antidepressant Dosage: Medication adjustments are often necessary because each individual’s body may react to medication differently.
  • Trying a Different Medication: Trial and error is sometimes necessary to find an effective treatment. Genetic testing processes are currently being developed to choose effective medication more accurately.
  • Using a Combination of Medications: Improved symptom relief may be achieved by using additional drugs to an antidepressant regimen, a method called medication augmentation. Popular augmentation options include atypical antipsychotics, antidepressants with different properties such as mirtazapine, and thyroid hormone. Medication choices should be made with care, considering side effects and potential drug interactions.

Adjust the Treatment Plan Beyond Medication

As antidepressants begin to improve an individual’s functioning, additional therapies can help with symptom improvement by addressing other needs.

Psychotherapy

Evidence shows that the combination of antidepressants and psychotherapy is often more effective than either treatment alone. Depending on an individual’s needs, both long-term and short-term therapy can be helpful.

  • Cognitive-Behavioral Therapy (CBT) focuses on the maladaptive interactions between thoughts, behaviors, and emotions and how those can lead to depression symptoms.
  • Acceptance and Commitment Therapy (ACT) emphasizes accepting difficult thoughts and emotions, remaining open to the present moment to experience their personal strength.
  • Narrative Therapy (NT) helps individuals challenge the stories they tell themselves and social constructs they live with, emphasizing growth and agency.

Deep Transcranial Magnetic Stimulation

Deep Transcranial Magnetic Stimulation (Deep TMS™) is a noninvasive medical device treatment for depression. Due to its proven safety and efficacy, it has been FDA-cleared to treat depression, making it a valuable augmentation to antidepressants and psychotherapy treatments.

During Deep TMS’s 20-minute sessions, targeted magnetic pulses are delivered to deep regions of the brain associated with depressive symptoms, stimulating neural connections and regulating brain activity in the targeted structures. A cushioned helmet is utilized for deeper, more accurate stimulation and effective relief.

During Deep TMS treatments, individuals may experience mild side effects such as a brief headache, without any long-lasting or significant side effects. Deep TMS does not necessitate the use of anesthesia or require a lengthy recuperation process, thereby allowing the patient to drive themselves to and from the treatment clinic. After several weeks of treatment, neural activity in these regions stabilizes and symptoms begin to improve.

Other Non-Medication Treatments for Depression

Additional non-medication treatments can support symptom remittance with minimal adverse effects.

  • Holistic Therapies: Yoga, meditation, exercise, and diet changes may help alleviate stress as enjoyable self-care activities.
  • Mental Health Apps: Apps can give access to teletherapy and support services, psychoeducational material, and coping skill training.
  • Deep Brain Stimulation (DBS): This treatment involves surgically placed brain implants that deliver stimulation based on an individual’s unique biomarkers. DBS has been used to treat other conditions and is being explored as an option for treatment-resistant depression.

Don’t Give Up When Antidepressants Don’t Work for You

Unsure what to do when antidepressants don’t work for you? Searching for effective depression treatment can be frustrating, but fortunately, there are many options. Don’t give up—consider your needs and explore different treatments to find one that works for you.