1. First and foremost, you should know that depression is a real illness, not a character flaw or a weakness. In this regard, it is no different from diabetes or hypertension, and it is highly responsive to appropriate treatment, which may include more than just medication alone.
2. You should know what to expect from antidepressant medication. At least 50 percent of individuals who will respond to antidepressants begin to demonstrate improvement within a week of treatment initiation. Likely you’ll begin to notice an increase in your energy level first, followed by a gradual improvement in mood and overall physical functioning.
3. Typical side effects. All antidepressants have similar efficacy, but most antidepressants have different side effects. Your prescriber should have informed you about the typical side effects of the antidepressant that was chosen for you. If not, there are countless sources where you can find this information. My book, Psychopharmacology: Straight Talk on Mental Health Medications, (Pesi, 2008) discusses the side effects of all of the widely used antidepressants. It is important to understand that many of the side effects you initially experience will diminish over time. So stay with it!
4. Antidepressants are not habit-forming or addictive, so you won’t get “hooked” on them.
5. If the first agent prescribed does not help you after an adequate trial period, others may be tried. Until science unlocks more of the mysteries of the brain, we’ll just have to live with a “no one-size-fits-all” approach.
6. Take enough for long enough. The best chance you have of getting an antidepressant to work for you is to continue taking it day by day unless the prescriber recommends otherwise. Keep a running diary of the symptoms you’re experiencing. For example, if before starting the medication you felt sad, empty, had lost interest in pleasurable activities, were sleeping poorly and losing weight, make notations in your diary as to which of these symptoms are improving and which ones are not. Keep your doctor informed, schedule follow-up appointments and make sure to report any bothersome side effects that continue to persist.
7. Never abruptly discontinue an antidepressant. Although not considered dangerous, some people who suddenly stop these drugs report “shock-like” sensations in their extremities, particularly the hands and feet. Discontinuation of antidepressants is best done gradually to spare the consumer this unnecessary upset.
8. Take your medication at the same time every day, whenever possible. If you miss a dose and then take it within one to three hours after the regularly scheduled time, that’s fine. If you remember having skipped the drug several hours later, then take it at the next regularly scheduled time.
9. Too much information can fuel a climate of hypervigilance and alarm. Reading up on your medication on the internet or devouring every word of information stapled to the prescription bag can worsen your fears. Most of what you read will never happen, and all of that extraneous information is really for the prescriber, not the consumer.
10. Beware of direct-to-consumer advertising. Remember that the media is not necessarily on your side, they’re out to sell their product and will glorify its benefits while casually mentioning its risks. It’s perfectly okay to ask whether a specific antidepressant may be helpful, but optimally the decision as to what drug is best for you is between you and your doctor. And that decision optimally will hinge on your personal and family history of depression as well as any previous experiences you may have had with antidepressants.
Antidepressant treatment has come a long way. Gone are the days of debilitating side effects and other complications that in some instances were worse than the depression itself. And remember that finding the drug that is right for you should always include and value your input into the decision making process.