How to Tell if Antidepressants Are Working

Antidepressants have an energizing effect. When they work, it's common for the sufferer to feel stronger and more energetic.

Antidepressants are drugs used primarily to relieve depressive symptomatology. Their use is also common in interventions for obsessive-compulsive disorder (OCD), social phobia, panic disorder, generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD).

Depression is an extremely common mood disorder that alters the biochemistry of the brain.  The administration of antidepressants seeks to correct the dysfunction of certain circuits and chemicals that transmit information throughout the brain. There are many types of antidepressant drugs. Among the most common are the following:

Selective serotonin reuptake inhibitors (SSRIs):

• Sertraline.
• Fluvoxamine.
• Fluoxetine.
• Paroxetine.
• Citalopram.
• Escitalopram.

Serotonin/norepinephrine reuptake inhibitors (SNRIs):

• Venlafaxine.
• Desvenlafaxine.
• Duloxetine.
• Milnacipran.
• Levomilnacipran.

Atypical antidepressants:

• Bupropion.
• Mirtazapine.
• Agomelatine.

Serotonin modulators:

• Nefazodone.
• Trazodone.
• Vilazodone.
• Vortioxetine.

Monoamine oxidase inhibitors (MAOIs):

• Selegiline.
• Moclobemide.
• Tranylcypromine.
• Isocarboxazid.
• Phenelzine.

Naturally, the first thing anyone prescribed these antidepressants wants to know is “How do I know if they’re working?” In this article, we’ll answer this question.

How well do antidepressants relieve symptoms?

It’s difficult to determine how well an antidepressant can help an individual. Health professionals usually suggest taking a medication that’s proven to be effective and relatively tolerable. If it doesn’t help as much as expected, it may need to be changed to another.

To a large extent, the benefit of any antidepressant depends on the severity of the depressive disorder. As a rule, the more severe it is, the more noticeable the changes will be. According to the Institute for Quality and Efficiency in Health Care, antidepressants are effective against chronic, moderate, and severe depression, but not particularly helpful in mild depression.

This same institute claims that studies involving adults with moderate or severe depression have shown the following:

• Without antidepressants: About 20 to 40 out of 100 people who took a placebo treatment saw an improvement in their symptoms within six to eight weeks.
• With antidepressants: About 40 to 60 out of 100 people who took antidepressants saw an improvement in their symptoms within six to eight weeks.

In other words, antidepressants improved symptoms in about 20 out of 100 people.

Side effects of antidepressants

Antidepressants can have side effects such as:

• Sexual dysfunction.
• Drowsiness.
• Weight gain.
• Insomnia.
• Anxiety.
• Dizziness.
• Headache.
• Dry mouth.
• Blurry vision.
• Nausea.
• Rashes.
• Tremors.

After a few weeks, these symptoms may begin to subside and the antidepressants will begin to take effect. Therefore, when starting this type of treatment, immediate results or improvements shouldn’t be expected. In fact, these drugs can take between four to six weeks to work.

How do you know if antidepressants are working?

It’s normal to feel bad or worse at the beginning of the treatment. However, after a few weeks, the antidepressants will start to have an effect. Signs that the antidepressants are working include the following:

• More energy. Antidepressants are working if the patient feels more energetic, with more strength to face their daily life.
• Mind broadening. People with depression tend to adopt a tunnel vision perspective. In other words, they think that there’s no solution to their problems and they only focus on negative aspects, especially those that confirm these core beliefs. Nevertheless, by taking antidepressants, they can begin to improve their perspective and start to look at situations from different angles.
• Improves mood. The key sign to knowing if antidepressants are working is to see if they’re doing what’s expected of them: that’s to improve the mood. If there’s no improvement, they’re probably not working.
• Improves sense of worth. As the negative mood gradually decreases, it’s possible that the patient’s perception of little value (low self-esteem) will also decrease. Therefore, an increase in self-esteem can be a sign that antidepressants are working. Nevertheless, it must be interpreted in integration with other aspects, since it’s unlikely for a drug, by itself, to increase self-esteem.

Next, we’ll review some signs that antidepressants aren’t working.

Signs that antidepressants aren’t working

Here are some of the signs that antidepressants may not be working:

• Worsening of sleep.
• Changes in appetite.
• Decreased energy.
• Increased fatigue.
• Low motivation.
• Apathy.
• Difficulty in focusing.
• Having to call in sick for work.
• Canceling social commitments.
• Worsening of the depression.
• No improvement in mood.

The reasons why antidepressants may not work are as follows:

• The dosage is too low.
• Another type of medication is required.
• They haven’t been taken for long enough.
• They may be interacting with other medications.
• The patient may have forgotten to take the proper dose.

Finally, taking antidepressants can be extremely useful in controlling depression, especially if they’re used alongside psychotherapeutic treatment. On the other hand, not all antidepressants work for everyone, nor do they all work in the same way. In fact, it’s possible that the professional won’t prescribe the right medication on their first attempt. However, the patient shouldn’t give up.

Finally, in order to ascertain if antidepressants are working, the limitations imposed by depression before and after treatment should be compared.