Improving the Effectiveness of Your Antidepressant

By Candida Fink MD
August 22, 2008

Syndicated from the Bipolar Blog

Antidepressants may be less effective in treating bipolar depression than in treating unipolar depression. However, there are steps you can take to improve the effectiveness of your antidepressant regardless of the type of depression you’re feeling:

Stick with it. Antidepressants usually don’t kick in until you’ve been taking them for about two to six weeks. (Yes, when you’re depressed, two to six weeks can seem like an eternity.) Because side effects can occur almost immediately while the benefits may take longer to appear, people often stop taking their antidepressant before it has a chance to work. Most side effects should dissipate over the course of a few days or weeks. For tips on how to minimize the negative side effects, see “Managing Bipolar Medication Side Effects.”
Remain in close contact with your doctor. Changing the dose or the times when you take your medications can often help minimize negative side effects while maximizing effectiveness, but don’t make adjustments without your doctor’s okay.
Keep taking the medication even after you start feeling better. If you’ve experienced several bouts of deep, long-lasting depression in the past, taking a maintenance dose of an antidepressant may be necessary.
Avoid alcohol, which can reduce the effectiveness of antidepressants.
Avoid mixing in any medications your doctor has not prescribed, including herbal, “all-natural” remedies, as these medications may cause unpredictable interactions. Keep your doctor, pharmacist, and even your dentist informed about any and all medications you are taking, including your antidepressant.
Obtain therapy. Studies show that antidepressants tend to be more effective, work faster, and their benefits last longer when medication is combined with psychotherapy (also known as talk therapy).

If one antidepressant doesn’t work or has unacceptable side effects, don’t give up on antidepressants altogether. Many antidepressants are available in several different classes, and some work better than others and can have different effects on different people. If your current medication’s not working, tell your doctor, “This isn’t working. We need to try something else.”

If your doctor is unavailable or you feel that he or she is not listening or not responding to what you’re saying, you may need to shop for another doctor. Changing doctors is no picnic (it often places you in a position of having to start over with someone new), but you may do better in the long run by finding someone who’s more available and responsive to your needs.