{"id":19106,"date":"2023-05-18T01:35:40","date_gmt":"2023-05-18T06:35:40","guid":{"rendered":"https:\/\/thepapergown.zocdoc.com\/?p=19106"},"modified":"2023-05-18T09:46:48","modified_gmt":"2023-05-18T14:46:48","slug":"how-can-i-tell-if-my-antidepressants-are-working","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/guides\/how-can-i-tell-if-my-antidepressants-are-working\/","title":{"rendered":"How Can I Tell If My Antidepressants Are Working?\u00a0"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Prescription drugs used to treat mental health conditions are called psychotropic drugs; about 16 percent of American adults have taken them, according to a 2020 report from the<\/span><a href=\"https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db380.htm\"> <span style=\"font-weight: 400;\">Centers for Disease Control and Prevention<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The two mental health conditions most commonly treated with medication are depression and anxiety, says Dr. Alex Dimitriu, founder of<\/span><a href=\"https:\/\/siliconpsych.com\/\"> <span style=\"font-weight: 400;\">Menlo Park Psychiatry and Sleep Medicine<\/span><\/a><span style=\"font-weight: 400;\">. Some people receive prescriptions for mental health medications through a psychiatrist, but primary care providers can also prescribe antidepressants, which are<\/span> <span style=\"font-weight: 400;\">one of the five main categories of psychotropic drugs.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Antidepressants are a first-line treatment for both depression and anxiety. \u201cAntidepressants don\u2019t make problems disappear,\u201d says Dimitriu, \u201cBut they can make things hurt a little less so people can do the work in therapy.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The efficacy of antidepressants is mixed. In one<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK361016\/\"> <span style=\"font-weight: 400;\">2020 report<\/span><\/a><span style=\"font-weight: 400;\">, 40 to 60 percent of people said they benefited from taking them. On the flip side, that means antidepressants didn\u2019t work for about half of respondents, a finding that\u2019s consistent with<\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22681165\/\"> <span style=\"font-weight: 400;\">one 2012 review<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Even when antidepressants are effective, they can take a while to kick in. While the precise timeline depends on the medication, it can take up to eight weeks for an antidepressant to work. But what does \u201cworking\u201d even mean? Carmen Kosicek, a psychiatric nurse practitioner and founder of<\/span><a href=\"https:\/\/www.alayhealthteam.org\/\"> <span style=\"font-weight: 400;\">Alay Health Team<\/span><\/a><span style=\"font-weight: 400;\">, says the answer varies, and that it\u2019s important for patients and providers to establish a shared definition of success.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Here\u2019s a guide to help you understand when an antidepressant is (or isn\u2019t) doing its job and how to discuss your progress with your provider.<\/span><\/p>\n<h3>Why medications work for some people and not others<\/h3>\n<p><b>Chemistry. <\/b><span style=\"font-weight: 400;\">There are several types of antidepressants, and they target a few different neurotransmitters, says Dr. Holly MacKenna, an integrative psychiatrist and founder of<\/span><a href=\"https:\/\/darawellnessnola.com\/\"> <span style=\"font-weight: 400;\">Dara Wellness in New Orleans.<\/span><\/a><span style=\"font-weight: 400;\"> Three of the most common types are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b><i>Selective serotonin reuptake inhibitors:<\/i><\/b><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/ssris\/art-20044825\"> <span style=\"font-weight: 400;\">SSRIs<\/span><\/a><span style=\"font-weight: 400;\"> such as Lexapro, Prozac and Zoloft increase the available supply of the<\/span><a href=\"https:\/\/www.nhs.uk\/mental-health\/talking-therapies-medicine-treatments\/medicines-and-psychiatry\/ssri-antidepressants\/overview\/\"> <span style=\"font-weight: 400;\">mood-regulating hormone<\/span><\/a><span style=\"font-weight: 400;\"> serotonin. This class of drugs can take <\/span><a href=\"https:\/\/www.webmd.com\/depression\/ssris-myths-and-facts-about-antidepressants\"><span style=\"font-weight: 400;\">up to six weeks<\/span><\/a><span style=\"font-weight: 400;\"> to start working. In 2022, researchers from the University College London <\/span><a href=\"https:\/\/www.theguardian.com\/society\/2022\/jul\/20\/scientists-question-widespread-use-of-antidepressants-after-survey-on-serotonin\"><span style=\"font-weight: 400;\">came out with a study<\/span><\/a><span style=\"font-weight: 400;\"> suggesting serotonin may play less of a role in depression than previously thought. But many psychiatrists\u2014and meta analyses of past studies\u2014<\/span><a href=\"https:\/\/www.nytimes.com\/2022\/11\/08\/well\/mind\/antidepressants-effects-alternatives.html\"><span style=\"font-weight: 400;\">support the use of SSRIs<\/span><\/a><span style=\"font-weight: 400;\"> and show that they work better than a placebo.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b><i>Serotonin and norepinephrine reuptake inhibitors:<\/i><\/b> <span style=\"font-weight: 400;\">SNRIs stop cells from reabsorbing serotonin and norepinephrine, a neurotransmitter that affects energy levels. Drugs in this class include Cymbalta, Effexor XR and Fetzima.<\/span> <span style=\"font-weight: 400;\">If you don\u2019t notice improvement after about <\/span><a href=\"https:\/\/my.clevelandclinic.org\/health\/treatments\/24797-snri#:~:text=How%20long%20does%20it%20take,feel%20better%20after%20this%20time.\"><span style=\"font-weight: 400;\">eight weeks<\/span><\/a><span style=\"font-weight: 400;\"> of taking an SNRI, reach out to your doctor.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b><i>Atypical antidepressants:<\/i><\/b> <span style=\"font-weight: 400;\">These medications don\u2019t neatly fit into one category because they don\u2019t all act on the same brain chemicals.<\/span><a href=\"https:\/\/www.sciencedirect.com\/topics\/pharmacology-toxicology-and-pharmaceutical-science\/dopamine-reuptake-inhibitors\"> <span style=\"font-weight: 400;\">Bupropion<\/span><\/a><span style=\"font-weight: 400;\"> (aka Wellbutrin), for example, prevents the body from reabsorbing feel-good chemical<\/span><a href=\"https:\/\/www.sciencedirect.com\/topics\/pharmacology-toxicology-and-pharmaceutical-science\/dopamine-reuptake-inhibitors\"> <span style=\"font-weight: 400;\">dopamine<\/span><\/a><span style=\"font-weight: 400;\">. Similar to SSRIs and SNRIs, it can take several weeks for atypical antidepressants to start working.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">If a patient isn\u2019t responding to one medication, it may be because they need one that affects a different neurotransmitter.<\/span><\/p>\n<p><b>Biology. <\/b><span style=\"font-weight: 400;\">Though medications can alter brain chemistry to improve mood, innate biological differences appear to influence the efficacy of some psychotropic medications. \u201cPeople\u2019s [bodies] metabolize medications differently,\u201d says MacKenna. Also, one <\/span><a href=\"https:\/\/www.nature.com\/articles\/s41380-019-0377-5?platform=hootsuite\"><span style=\"font-weight: 400;\">2019 study<\/span><\/a><span style=\"font-weight: 400;\"> found that SSRIs were less likely to alleviate depression in people with abnormally shaped serotonergic neurons (which produce serotonin).<\/span><\/p>\n<p><b>Interference. <\/b><span style=\"font-weight: 400;\">Alcohol and other medications can affect your brain and mood in a way that counteracts the medication\u2019s effects. Some of these interactions can also be dangerous to your physical health. Speak with your provider about any other medications you are taking and your drinking habits.<\/span><\/p>\n<h3>Signs medication is working<\/h3>\n<p><b>Someone in your life notices that you seem different. <\/b><span style=\"font-weight: 400;\">\u201cOften, when one is in a state of depression or anxiety, that [sadness or anxiousness] becomes the go-to feeling,\u201d MacKenna says.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">But medications can change the brain over time. Though it may take several weeks for you to notice significant changes, a loved one may pick up on more understated differences sooner.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cOnce our brain starts to adjust to the medication, our behaviors and facial expressions will begin to subtly change,\u201d says MacKenna. \u201cThose who see us every day will pick up on these changes before we realize we are beginning to feel better.\u201d<\/span><\/p>\n<p><b>You start sleeping better. <\/b><span style=\"font-weight: 400;\">Studies suggest the relationship between healthy sleep and mental wellbeing is bidirectional. That means getting enough high-quality sleep leads to lower levels of<\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25128225\/\"> <span style=\"font-weight: 400;\">depression<\/span><\/a><span style=\"font-weight: 400;\"> and<\/span><a href=\"https:\/\/www.nature.com\/articles\/s41562-019-0754-8\"> <span style=\"font-weight: 400;\">anxiety<\/span><\/a><span style=\"font-weight: 400;\">, and not feeling anxious or depressed leads to more restful nights.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cI don\u2019t usually hear people saying, \u2018I\u2019m running through fields of daisies,\u2019\u201d Kosicek says. \u201cThey usually say, \u2018I\u2019m sleeping better.\u2019\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">That said, <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5548844\/\"><span style=\"font-weight: 400;\">different antidepressants can have different effects on sleep<\/span><\/a><span style=\"font-weight: 400;\">: Some may improve sleep while others may cause insomnia or <\/span><a href=\"https:\/\/www.ajmc.com\/view\/antidepressant-use-linked-with-impaired-rem-sleep-quality-of-life\"><span style=\"font-weight: 400;\">hinder REM sleep<\/span><\/a><span style=\"font-weight: 400;\">. Your doctor might suggest <\/span><a href=\"https:\/\/www.webmd.com\/depression\/sleep-problems-and-depression\"><span style=\"font-weight: 400;\">taking your medication in the morning<\/span><\/a><span style=\"font-weight: 400;\"> to reduce the impact on your sleep.<\/span><\/p>\n<p><b>Your work performance improves. <\/b><span style=\"font-weight: 400;\">Mood disorders can affect your ability to perform well at work.<\/span><a href=\"https:\/\/www.who.int\/teams\/mental-health-and-substance-use\/mental-health-in-the-workplace\"> <span style=\"font-weight: 400;\">The World Health Organization<\/span><\/a><span style=\"font-weight: 400;\"> estimates that depression and anxiety cost the global economy $1 trillion each year in lost productivity. But<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5895453\/\"> <span style=\"font-weight: 400;\">some research<\/span><\/a><span style=\"font-weight: 400;\"> links antidepressants to enhanced work productivity.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cFor many people with depression and anxiety, there is a lot of wasted brain energy thinking about things that are not productive,\u201d says Dimitriu. \u201cMedications make it easier for people to let go of the past and direct that energy into the future.\u201d<\/span><\/p>\n<p><b>You notice a change in your energy. <\/b><span style=\"font-weight: 400;\">Mood disorders can have a negative impact on your energy, both how much you have and how it feels. Medications may help.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dimitriu says patients with depression will often come in and note they have more motivation and energy to do the things they love, such as watching a baseball game. Meanwhile, patients with anxiety often report having a bit less negative energy: \u201cPeople will say, \u2018Wow, there\u2019s actually peace and stillness. That\u2019s a wonderful feeling.\u2019\u201d\u00a0<\/span><\/p>\n<h3>Signs medication isn\u2019t working<\/h3>\n<p><b>You feel apathetic. <\/b><span style=\"font-weight: 400;\">When you bang your knee, you might numb the pain with ice. But medication for mental health doesn\u2019t serve the same purpose.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cYou need to feel things to be able to deal with life,\u201d Kosicek says. \u201cFeeling numb is not what we are looking for.\u201d<\/span><\/p>\n<p><b>You feel worse (or no different) after four to eight weeks.. <\/b><span style=\"font-weight: 400;\">While you might experience some initial side effects like fatigue, stomach upset or dizziness, you should start feeling better about four to eight weeks after starting meds. Dimitriu advises that patients give it that amount of time, as early side effects are common.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cThere can be a wobble,\u201d Dimitriu says. \u201cThings can get a little bit worse before they get better.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">But if you aren\u2019t noticing a difference after the first several weeks, it could be a sign that the medication isn\u2019t working. Call your provider if you\u2019re unsure; they might suggest trying a different type of medication.<\/span><\/p>\n<h3>What to ask and tell your provider about medication<\/h3>\n<p><b>Ask questions. <\/b><span style=\"font-weight: 400;\">Experts recommend asking your provider some questions before you start taking medication and as you go along. For starters, you should understand their reason for prescribing it.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cAsk, \u2018Why do you think this is the medication for me?\u2019\u201d Kosicek suggests. \u201cThe prescriber should say, \u2018You said this is the problem, and that is what this medication is for.\u2019\u201d<\/span><b>\u00a0<\/b><\/p>\n<p><span style=\"font-weight: 400;\">It\u2019s also beneficial to ask about side effects before starting and as you experience them.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cTransparency can prevent you from going down a Google rabbit hole,\u201d MacKenna says, adding that your provider can help you understand what is and isn\u2019t normal.<\/span><\/p>\n<p><b>Label feelings differently. <\/b><span style=\"font-weight: 400;\">We often think of our feelings as \u201cgood\u201d or \u201cbad,&#8221; Dimitriu says. He suggests delving deeper.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;Break it down into overall mood states,\u201d he says. \u201cOverall, how happy or sad do you feel? Overall, how anxious do you feel? I also like to look at motivation and sleep.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As you continue treatment, this granular level of thinking can help you and your provider examine progress.<\/span><\/p>\n<p><b>Collect and discuss data. <\/b><span style=\"font-weight: 400;\">Dimitriu says that his patients sometimes have difficulty recalling how they felt before taking the medication. But if you confuse your pre-medication feelings with your current ones, it\u2019s challenging to evaluate efficacy. Journaling can help.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cI encourage my patients to take careful notes on how they felt before an intervention and how they feel after 15, 30 and 60 days,\u201d Dimitriu says.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Before sessions, MacKenna suggests using your journal to make a list. At an appointment, tell your provider how many days or weeks you\u2019ve experienced issues or improvements.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cData is hard to argue against,\u201d she says. \u201cIt gives you information so you and your doctor can have a more targeted conversation rather than talking in generalities.\u201d<\/span><\/p>\n<h3>Medication isn\u2019t magic<\/h3>\n<p><span style=\"font-weight: 400;\">Even medication that works isn\u2019t a cure-all. Dimitriu suggests a holistic treatment approach that includes strategies like talk therapy, exercise and meditation.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cDon\u2019t just sit back and wait for the medicine to work,\u201d he says. \u201cIt\u2019s usually more than just the medicine that makes people better.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Even if other, non-pharmacological treatments didn\u2019t have a measurable impact on your mental health prior to medication, they may be more effective in conjunction with it. Your provider can help you put together a well-rounded treatment plan.<\/span><\/p>\n<hr \/>\n<h1 class=\"p1\" style=\"text-align: center;\"><span class=\"s1\">Ready to book an appointment? Visit <a href=\"https:\/\/www.zocdoc.com\/psychologists\"><span class=\"s2\">Zocdoc.<\/span><\/a><\/span><\/h1>\n","protected":false},"excerpt":{"rendered":"<p>A guide to help you understand when an antidepressant is (or isn\u2019t) doing its job and how to discuss your progress with your doctor.<\/p>\n","protected":false},"author":64,"featured_media":20529,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[227],"tags":[12,19,90,166,41,129,106],"class_list":["post-19106","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guides","tag-anxiety","tag-depression","tag-feature","tag-medication","tag-mental-health","tag-rx","tag-treatment","reviewer-dr-nassim-assefi"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>How Can I Tell If My Antidepressants Are Working?\u00a0 - Guides<\/title>\n<meta name=\"description\" content=\"A guide to help you understand when an antidepressant is (or isn\u2019t) doing its job and how to discuss your progress with your doctor. from\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.zocdoc.com\/blog\/guides\/how-can-i-tell-if-my-antidepressants-are-working\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"How Can I Tell If My Antidepressants Are Working?\u00a0 - Guides\" \/>\n<meta property=\"og:description\" content=\"A guide to help you understand when an antidepressant is (or isn\u2019t) doing its job and how to discuss your progress with your doctor. from\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.zocdoc.com\/blog\/guides\/how-can-i-tell-if-my-antidepressants-are-working\/\" \/>\n<meta property=\"og:site_name\" content=\"The Paper Gown\" \/>\n<meta property=\"article:published_time\" content=\"2023-05-18T06:35:40+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-05-18T14:46:48+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/zocdoc.com\/blog\/wp-content\/uploads\/2021\/06\/antidepressants-working.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"846\" \/>\n\t<meta property=\"og:image:height\" content=\"460\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Beth Ann Mayer\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Beth Ann Mayer\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.zocdoc.com\/blog\/guides\/how-can-i-tell-if-my-antidepressants-are-working\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.zocdoc.com\/blog\/guides\/how-can-i-tell-if-my-antidepressants-are-working\/\"},\"author\":{\"name\":\"Beth Ann Mayer\",\"@id\":\"https:\/\/www.zocdoc.com\/blog\/#\/schema\/person\/3742be248c23868e21def918e8f3d599\"},\"headline\":\"How Can I Tell If My Antidepressants Are Working?\u00a0\",\"datePublished\":\"2023-05-18T06:35:40+00:00\",\"dateModified\":\"2023-05-18T14:46:48+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.zocdoc.com\/blog\/guides\/how-can-i-tell-if-my-antidepressants-are-working\/\"},\"wordCount\":1563,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/www.zocdoc.com\/blog\/#organization\"},\"image\":{\"@id\":\"https:\/\/www.zocdoc.com\/blog\/guides\/how-can-i-tell-if-my-antidepressants-are-working\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/thepapergown.wpengine.com\/wp-content\/uploads\/2021\/06\/antidepressants-working.jpg\",\"keywords\":[\"Anxiety\",\"Depression\",\"Feature\",\"Medication\",\"Mental Health\",\"Rx\",\"Treatment\"],\"articleSection\":[\"Guides\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.zocdoc.com\/blog\/guides\/how-can-i-tell-if-my-antidepressants-are-working\/\",\"url\":\"https:\/\/www.zocdoc.com\/blog\/guides\/how-can-i-tell-if-my-antidepressants-are-working\/\",\"name\":\"How Can I Tell If My Antidepressants Are Working?\u00a0 - 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