Making Your Medication Work For You

Patient Expert

What do you do if this happens: you get yourself together and not only make an appointment with a doctor to get your depression treated, but actually manage to keep the appointment, he or she prescribes an antidepressant, you take it faithfully, but see no change? Unfortunately this scenario is fairly common, and is definitely one of the most frustrating aspects of treatment for depression.

Finding the most effective antidepressant to treat depression is at this point far from an exact science. It's not as easy as prescribing insulin for diabetes or penicillin for an infection. In determining what medication to prescribe for depression, especially when it's the first time the patient has been treated for depression, doctors for the most part take their best guess, based on their past experience and the prevailing wisdom. They consider the type of depression the patient suffers from, other medications he or she is taking, and several other factors.

Sometimes the first one out of the gate works, but sometimes patients have to try three, four or more medications before one "clicks" with their chemistry.

If this happens to you, don't despair. Just be aware that this is common and don't give up on finding one that works. Here are some ideas to consider:

● Be your own second opinion. Buy a medication "bible" like The Pill Book or The PDR Pocket Guide to Prescription Drugs and get to know your antidepressant inside out. You should know where the dosage you are taking falls in the normal range and how quickly it's expected to start working. You also should know what food or drinks to avoid and what other medication, prescription and non-prescription, might contraindicate with it.

● Ask your doctor about raising your dosage. If your antidepressant has been partially successful in that you feel a bit better since starting it, but not back to normal, your doctor should consider raising the dosage before switching you to a new medication. I have had the level of all the antidepressants I've been on (three different ones) raised at some point.

● Consider trying an older antidepressant. Older classes of antidepressants, such as tricyclics, have fallen out of favor because they tend to have more side effects than the newer classes, such as SSRIs like Prozac, but they do work. I was on one successfully for ten years. If the newer antidepressants aren't working for you, ask your doctor to try one of the older ones. Having side effects is not a big deal when the antidepressant is working, trust me.

● Get to know your exact diagnosis. Whether you have dysthymia, major depression or atypical depression determines which antidepressant the doctor will start you on. If your doctor prescribed one that isn't a usual choice for your diagnosis, ask why. There may be a good reason that has to do with another aspect of your health, but it's a good idea to find out why he or she deviated from the norm.

● Get precise directions on the best way to take your medication from your doctor. I just found out (after a few years on Wellbutrin) that my two daily doses should be taken only a few hours apart, instead of the twelve hours I assumed was meant by "twice daily." Changing the spacing of doses has made a difference.

Taking these steps, or keeping them in mind as options, will increase your chances of success with antidepressant treatment. Remember that the chances are very good that your doctor will be able to find an effective medicine for you. As hard as it is, try to be patient and hopeful and keep trying different medications. When you find the one that works, it makes a world of difference.