Am Fam Physician. 2015;92(2):online
See related article on pharmacologic management of depression in adults
How do medicines for depression work?
Medicines for depression work by increasing levels of chemicals in your brain that help you feel good. These medicines can help people with mild or moderate depression, but they're more effective in people with very bad depression. These medicines work best if you take them every day. They don't work if you take them only on days when you feel bad.
How long do they take to work?
It's different for everyone. Some people start feeling better after just a couple of weeks. Others don't notice any improvements for up to eight weeks. Keep in mind that the changes might be subtle at first. For example, you may notice that your appetite is coming back or that you're sleeping better, even though you still feel the same.
What if I don't notice a difference after eight weeks?
Don't give up. Talk to your doctor about your options. You might need a higher dose of your medicine or a different medicine. Don't increase your dose without talking to your doctor first.
Are there side effects?
Some medicines are less likely to cause side effects than others. Side effects are usually mild, such as headache, stomach upset, or diarrhea. Sometimes these side effects go away after about a week as your body gets used to the medicine. Talk to your doctor if they don't go away. He or she might want you to switch to a different medicine.
Medicines for depression might increase the risk of suicide during the first three months, especially in people younger than 25 years. Tell your family and close friends about this, and ask them to help if they notice anything that concerns them.
Are these medicines addictive?
They aren't addictive, but you might have withdrawal symptoms if you suddenly stop taking your medicine. You might have flu-like symptoms, trouble sleeping, nausea, and balance problems. You might have a “pins and needles” feeling, and you might feel keyed up or jittery. But if you slowly cut down your dose after talking with your doctor, you should be fine.
Is there anything else that can help with my depression?
Yes. Talk to your doctor about counseling, especially a type called cognitive behavior therapy (CBT). Depressed feelings are often caused or made worse by how you think about yourself and the world, and by how you react to things. CBT helps you change these thoughts and behaviors in ways that can help you feel better.
Where can I get more information?
American Academy of Family Physicians
AAFP's Patient Information Resource