10 FAQs About Antidepressantsby Jerry Kennard, Ph.D. Medical Reviewer
Are antidepressants better than other forms of therapy?
It depends. Mild depression seems to respond better to psychotherapy or counseling. Moderate depression responds as well to psychotherapy or counseling as it does to antidepressants. Major depressive episodes appear to respond best to antidepressants and compared with ‘talk therapies’ the positive effects are generally seen much more quickly.
How effective are antidepressants?
It can take a few weeks, sometimes around six weeks, until the effects of antidepressants begin to be seen. In trials of volunteers with moderate to severe depression, nearly twice as many reported improvement (around 6 in 10) as compared with those taking placebo (dummy pills).
Why have I been prescribed antidepressants when I’m not depressed?
Antidepressants have been found to offer relief to conditions other than depression. People with severe anxiety and panic may be offered antidepressants. Other conditions such as post-traumatic stress, obsessive- compulsive disorder, arthritis, migraine, nerve damage, low back pain may also be relieved by antidepressants.
How many types of antidepressant are there?
Around 30, at the last count. Older classes of antidepressant, known as tricyclics and MAOIs are still effective for some people. Even with the newest generation of antidepressants, people find greater benefits and/or fewer side effects. This means it may take a little trial and error before an appropriate antidepressant is found.
How bad are the side effects?
All drugs have potential side effects, including the ones any of us can pick from the shelves. The fact that a drug can have side effects doesn’t mean it will. With antidepressants most people can feel them having an effect, often in terms of drowsiness, a little nausea, or other fairly tolerable issues that wear off in a couple of weeks. It is possible to experience stronger side effects in which case the type of drug may need to be changed.
Will I have to stop work?
It’s much more likely that your depression will be the cause of time away from work. Antidepressants are designed to alleviate the worst symptoms of depression but some, especially the older classes, are prone to making you more tired and less able to concentrate. If you drive or operate machinery it is worth talking things over with your doctor.
Could I become addicted?
No. Addictive substances typically require a steady increase in the substance in order to maintain their effect. Equally, people don’t crave antidepressants or go ‘cold turkey’ when they come off. The body does however adapt to the use of antidepressants so withdrawal-like symptoms can occur unless the dosage is reduced gradually and the drug is allowed to wash out of the body.
I’ve heard that antidepressants can cause suicidal ideas?
There is some evidence, especially in young people, for increased suicidal thoughts. This does not necessarily translate into suicidal acts. Although people mature at different rates, the under 25 age group are probably most at risk from ideas of suicide or self-harm. For this reason, younger people should be made very aware of the risks, and be monitored more closely.
Will antidepressants actually cure my depression?
Clinicians usually talk about relief of symptoms rather than cure. Depression is a complicated beast and antidepressants can’t alter or change the reasons you may have become depressed. The passage of time combined with antidepressants and possibly other forms of therapy are all useful tools in the fight against depression. For many people, antidepressant use gives them the time to settle and reflect on how things can be changed.
How long will I have to take antidepressants for?
The recommended minimum time period is six months, although some people find they need to take them for years. Depression can return so it’s important not to stop taking medication sooner that recommended. Some people on longer term antidepressants feel their dosage isn’t as effective as it once was, in which case a clinical consultation will be required.