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Approved by Dr Adil Jawad MBBS, DPM, FRCPsych — Clinical Lead for MindClinix

Finding the right antidepressant for your mental health condition can be a lengthy process as medications can work differently for different people. 

In many cases, the process can seem like trial and error, with several medications tried at varying strengths before the most effective combination is reached. If you are currently taking, or are considering taking, antidepressants this article is designed to help you on your journey to feeling better.

Our aim is to provide basic information, as well as some helpful tips …

 

What are antidepressants?

Antidepressants are psychiatric medication that have been licensed to treat a variety of conditions, including depression, anxiety, bulimia and even chronic pain. While many antidepressants are available on prescription from your GP, some can only be prescribed if you are under the supervision of a mental health professional.

 

How do antidepressants work?

Antidepressants are designed to increase the activity of certain chemicals in the brain, such as noradrenaline and serotonin, which are neurotransmitters. They pass messages between the nerve cells in your brain, so controlling their actions will affect your mood.

While antidepressants can be an effective treatment for the symptoms of mental health conditions, they may not tackle the root causes of the problem. That’s why GPs will often recommend they are used in conjunction with talking therapy sessions with a psychiatrist.

It’s normal for patients to find that some antidepressants are more effective than others, while some people might find they are not the right treatment for them. 

 

What types of antidepressants are available?

There are many different antidepressants available; each one is designed to affect a particular brain function. They include the following:

  • Monoamine oxidase inhibitors (MAOIs): these prevent the enzyme monoamine oxidase breaking down noradrenaline and serotonin. MAOIs should only be prescribed by a specialist.
  • Selective serotonin reuptake inhibitors (SSRIs): the UK’s most common antidepressant, they work by blocking the reabsorption of serotonin by nerve cells. This allows serotonin to have a longer effect on your body. 
  • Serotonin and noradrenaline reuptake inhibitors (SNRIs): these do a similar job to SSRIs, but also affect the reuptake of noradrenaline.
  • Tricyclics: these also target noradrenaline and serotonin levels, but also affect other chemicals in your body which can cause side effects.

 

How effective are antidepressants?

Research has shown that antidepressants are most effective for those with moderate or severe depression. They are not typically prescribed to patients with mild depression, who are usually pointed towards therapy sessions.

According to The Royal College of Psychiatrists, around 50 to 65% of people using antidepressants for depression will notice an improvement. This compares with 25 to 30% for those taking a placebo.

https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/antidepressants

 

How long will treatment last?

Finding the right medication can be tricky as different people will have different reactions to antidepressants. If you do not notice an improvement after several months, you may find that switching to a different antidepressant might be the solution. 

Patients need to realise that changing medications does not mean that your symptoms are not treatable, it just requires patience and working with your GP or mental health professional.

Medical professionals will usually start patients on the lowest dose of antidepressants necessary, which will take several weeks to take effect. If patients suffer mild side effects, they should continue the medication as the symptoms should pass.

If you do not feel any noticeable improvements within four weeks, you should speak to your doctor or mental health professional. They could increase your dose or recommend a different medicine.

A full course of antidepressants will normally last six months, although those with recurring symptoms may need to take them indefinitely.

 

How do I know if my antidepressants are working?

The main thing to remember is that antidepressants are intended to make you feel more — not less — like yourself. It’s natural for patients to worry that medication might change who they are, but antidepressants should not change your personality. They are intended to make you feel like yourself, while removing feelings of depression or anxiety.

Antidepressants are designed to clear your head. They are not intended to numb the brain.

If you are unsure that your medication is working, there are a few steps you can take:

  • Review your medication: stay in regular contact with your GP or mental health professional so that they can check on your progress, including any side effects.
  • Alternative treatments: discuss other options with your GP, such as different medication or therapy.
  • Get a second opinion: if you have serious concerns about your diagnosis or treatment, you have the right to ask your GP to refer you to another health professional.
  • Ask a pharmacist: if you would like more information on your medication and any side effects, you could try your high street pharmacist.
  • Be patient: some medications may take longer to start working, so ensure you take the full course prescribed before making a decision.

How will I know when to come off antidepressants?

You should be in regular contact with your doctor or mental health professional, who is in the best position to judge the effect of your treatment. If your symptoms have improved, your doctor may decide that you are ready to come off the medication.

You should not stop taking the tablets immediately. You will be advised to reduce your dosage over several weeks, or even months. This is to prevent unwanted withdrawal symptoms.

 

Do you need help with depression?

The good news is that with the right treatment and support, most people who suffer from depression can go on to make a full recovery. Typical treatments include lifestyle changes, therapy and medicine. 

If you think that you are suffering from depression, take a positive step forward by seeking the support of family and friends. However, it may also be necessary to seek professional help.

We offer a fast, discreet and affordable way to get a medical diagnosis and treatment recommendations for all mental health conditions. Find out more at Mind Clinix

Further information: 

Sources:

https://bmjopen.bmj.com/content/3/8/e003320

Written by Barry Hunt.
October 2021.

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