Table of ContentsView AllTable of ContentsHow Antidepressants WorkHow Long Till They Work?Signs It’s WorkingIf It Isn’t WorkingSide EffectsLength of Treatment
Table of ContentsView All
View All
Table of Contents
How Antidepressants Work
How Long Till They Work?
Signs It’s Working
If It Isn’t Working
Side Effects
Length of Treatment
In general, you can expect an antidepressant to take about four to eight weeks to make a noticeable difference in your depression symptoms. Some people may start to notice improvements sooner, after about one to two weeks.
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There are avarietyof antidepressant drug classes, such as:
How Long Do They Take to Work?
Most antidepressants take around four to eight weeks to work, but everyone’s response to these medications is different.
Some people may feel improvement sooner, like after one to two weeks, but if you don’t, keep taking the antidepressant regularly until you’ve hit eight weeks before deciding whether it’s going to work or not. At that point, discuss the best next steps with your healthcare provider.
Signs Your Antidepressant Is Working
Some early hints you may notice that your antidepressant is starting to work include:
Other people may notice improvements in your focus or energy even before you do. If you begin to feel these improvements, this is an excellent sign that your antidepressant is helping your symptoms and may continue to help even more. Make sure to keep taking it as prescribed for the best chance of further improvements.
What Should I Do if My Antidepressant Isn’t Working?
Unfortunately, not every antidepressant works for every person. Only about 50% to 60% of people may benefit from the first antidepressant they try.
Sometimes, treatment with one medication isn’t enough to help with symptoms of depression. You may experience what is called a partial response to a medication, wherein your symptoms improve but not as much as they could, or maybe some symptoms still linger.
If this happens, you and your healthcare provider may decide to try a different medication altogether, or they may feel that adding another medication to your regimen would make remission more likely.
One other newer treatment option for TRD isketamine, a drug that has been used since the 1970s for anesthesia. It has been growing in popularity and investigation for depression treatment in recent years. The drug is available as an intravenous infusion or an intranasal product called Spravato (esketamine).
Pharmacogenetics for Depression Treatment
One study of over 1,500 people found that prescribing medications based on the results of a 12-gene test significantly reduced side effects compared to standard care, guideline-based treatment.
Pharmacogenetic testingis not a guarantee that the chosen antidepressant will be perfect, but it may lower your risk of medication side effects and shorten the time you take to find the best medication option for you. Talk to your healthcare provider if you are curious about pharmacogenetic testing and whether it may optimize your treatment.
What Side Effects to Expect
Side effectsare unfortunately common among people taking antidepressants. As many as 75% of people taking them experience some sort of adverse effect. Some common examples include:
Some side effects are temporary and may wear off or weaken over time. But if side effects are intolerable or do not decrease over the six to eight weeks you are trialing a new medication, talk to your healthcare provider about trying a different drug or drug class.
For How Long Do You Need to Take Antidepressants?
There is not much evidence that taking antidepressants for any given amount of time will prevent relapse after you stop taking them. In other words, antidepressants may only make you feel better as long as you keep taking them.
One study analyzed people who weaned themselves off of antidepressants in hopes that their depression symptoms would not return.The study included people who had been taking one of the most common antidepressants (Celexa [citalopram], Zoloft [sertraline], Prozac [fluoxetine], or Remeron [mirtazapine]) continuously for at least nine months and felt well enough to consider stopping.
Half of the people continued their antidepressant as normal, while the other half were given placebo (inactive) pills at doses that slowly tapered off until the pills contained no drug. More people in the placebo group relapsed than in the treatment group and generally had worse depression and anxiety scores, but 40% of the placebo group did not relapse.
If you have been taking an antidepressant for around six months to a year and feel like you don’t need it anymore, discuss stopping the medication with your healthcare provider.
It’s best to discuss how tocome off the medicationwith your prescriber instead of simply stopping the drug abruptly. Some antidepressants come with a risk of withdrawal symptoms, particularly MAOIs, TCAs, Effexor (venlafaxine), andPaxil (paroxetine).
Summary
Antidepressants can be an excellent tool for helping people manage debilitating symptoms of depression. If you’re trying a new antidepressant, make sure to take it as prescribed for at least eight weeks in order to give it enough time to make a noticeable difference. If at that point you still have not noticed any improvement, discuss further options with your healthcare provider, such as changing or adding medications.
For many, the first antidepressant they try is unsuccessful. It may take some trial and error or even trying a tool such as pharmacogenetics, which may lead healthcare providers to the right antidepressant sooner based on some of the genetic information they collect.
That antidepressants should be justone part of a treatment planfor depression is also important to note. They may help people reach a baseline that makes them feel more motivated to access other forms of care, such as different types of psychotherapy, social support, and lifestyle changes.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Frodl T.Recent advances in predicting responses to antidepressant treatment.F1000Res. 2017;6:F1000 Faculty Rev-619. doi:10.12688/f1000research.10300.1Harmer CJ, Goodwin GM, Cowen PJ.Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant drug action.Br J Psychiatry. 2009;195(2):102-8. doi:10.1192/bjp.bp.108.051193 (allowing although older)Centre for Addiction and Mental Health.Antidepressant medications.DailyMed. Label:Abilify—aripiprazole tabletDailyMed.Label: Rexulti—brexpiprazole tablet.Reif A, Bitter I, Buyze J, et al.Esketamine nasal spray versus quetiapine for treatment-resistant depression.N Engl J Med. 2023;389(14):1298-1309. doi:10.1056/NEJMoa2304145Swen JJ, van der Wouden CH, Manson LE, et al. Ubiquitous Pharmacogenomics Consortium.A 12-gene pharmacogenetic panel to prevent adverse drug reactions: an open-label, multicentre, controlled, cluster-randomised crossover implementation study.Lancet. 2023;401(10374):347-356. doi:10.1016/s0140-6736(22)01841-4Pillinger T, Howes OD, Correll CU, et al.Antidepressant and antipsychotic side-effects and personalised prescribing: a systematic review and digital tool development.Lancet Psychiatry. 2023;10(11):860-876. doi:10.1016/s2215-0366(23)00262-6Duffy L, Clarke CS, Lewis G, et al.Antidepressant medication to prevent depression relapse in primary care: the ANTLER RCT. Health Technol Assess. 2021;25(69):1-62. doi:10.3310/hta25690Henssler J, Heinz A, Brandt L, Bschor T.Antidepressant withdrawal and rebound phenomena: a systematic review.Dtsch Arztebl Int. 2019;116(20):355-361. doi:10.3238/arztebl.2019.0355
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Frodl T.Recent advances in predicting responses to antidepressant treatment.F1000Res. 2017;6:F1000 Faculty Rev-619. doi:10.12688/f1000research.10300.1Harmer CJ, Goodwin GM, Cowen PJ.Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant drug action.Br J Psychiatry. 2009;195(2):102-8. doi:10.1192/bjp.bp.108.051193 (allowing although older)Centre for Addiction and Mental Health.Antidepressant medications.DailyMed. Label:Abilify—aripiprazole tabletDailyMed.Label: Rexulti—brexpiprazole tablet.Reif A, Bitter I, Buyze J, et al.Esketamine nasal spray versus quetiapine for treatment-resistant depression.N Engl J Med. 2023;389(14):1298-1309. doi:10.1056/NEJMoa2304145Swen JJ, van der Wouden CH, Manson LE, et al. Ubiquitous Pharmacogenomics Consortium.A 12-gene pharmacogenetic panel to prevent adverse drug reactions: an open-label, multicentre, controlled, cluster-randomised crossover implementation study.Lancet. 2023;401(10374):347-356. doi:10.1016/s0140-6736(22)01841-4Pillinger T, Howes OD, Correll CU, et al.Antidepressant and antipsychotic side-effects and personalised prescribing: a systematic review and digital tool development.Lancet Psychiatry. 2023;10(11):860-876. doi:10.1016/s2215-0366(23)00262-6Duffy L, Clarke CS, Lewis G, et al.Antidepressant medication to prevent depression relapse in primary care: the ANTLER RCT. Health Technol Assess. 2021;25(69):1-62. doi:10.3310/hta25690Henssler J, Heinz A, Brandt L, Bschor T.Antidepressant withdrawal and rebound phenomena: a systematic review.Dtsch Arztebl Int. 2019;116(20):355-361. doi:10.3238/arztebl.2019.0355
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Frodl T.Recent advances in predicting responses to antidepressant treatment.F1000Res. 2017;6:F1000 Faculty Rev-619. doi:10.12688/f1000research.10300.1Harmer CJ, Goodwin GM, Cowen PJ.Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant drug action.Br J Psychiatry. 2009;195(2):102-8. doi:10.1192/bjp.bp.108.051193 (allowing although older)Centre for Addiction and Mental Health.Antidepressant medications.DailyMed. Label:Abilify—aripiprazole tabletDailyMed.Label: Rexulti—brexpiprazole tablet.Reif A, Bitter I, Buyze J, et al.Esketamine nasal spray versus quetiapine for treatment-resistant depression.N Engl J Med. 2023;389(14):1298-1309. doi:10.1056/NEJMoa2304145Swen JJ, van der Wouden CH, Manson LE, et al. Ubiquitous Pharmacogenomics Consortium.A 12-gene pharmacogenetic panel to prevent adverse drug reactions: an open-label, multicentre, controlled, cluster-randomised crossover implementation study.Lancet. 2023;401(10374):347-356. doi:10.1016/s0140-6736(22)01841-4Pillinger T, Howes OD, Correll CU, et al.Antidepressant and antipsychotic side-effects and personalised prescribing: a systematic review and digital tool development.Lancet Psychiatry. 2023;10(11):860-876. doi:10.1016/s2215-0366(23)00262-6Duffy L, Clarke CS, Lewis G, et al.Antidepressant medication to prevent depression relapse in primary care: the ANTLER RCT. Health Technol Assess. 2021;25(69):1-62. doi:10.3310/hta25690Henssler J, Heinz A, Brandt L, Bschor T.Antidepressant withdrawal and rebound phenomena: a systematic review.Dtsch Arztebl Int. 2019;116(20):355-361. doi:10.3238/arztebl.2019.0355
Frodl T.Recent advances in predicting responses to antidepressant treatment.F1000Res. 2017;6:F1000 Faculty Rev-619. doi:10.12688/f1000research.10300.1
Harmer CJ, Goodwin GM, Cowen PJ.Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant drug action.Br J Psychiatry. 2009;195(2):102-8. doi:10.1192/bjp.bp.108.051193 (allowing although older)
Centre for Addiction and Mental Health.Antidepressant medications.
DailyMed. Label:Abilify—aripiprazole tablet
DailyMed.Label: Rexulti—brexpiprazole tablet.
Reif A, Bitter I, Buyze J, et al.Esketamine nasal spray versus quetiapine for treatment-resistant depression.N Engl J Med. 2023;389(14):1298-1309. doi:10.1056/NEJMoa2304145
Swen JJ, van der Wouden CH, Manson LE, et al. Ubiquitous Pharmacogenomics Consortium.A 12-gene pharmacogenetic panel to prevent adverse drug reactions: an open-label, multicentre, controlled, cluster-randomised crossover implementation study.Lancet. 2023;401(10374):347-356. doi:10.1016/s0140-6736(22)01841-4
Pillinger T, Howes OD, Correll CU, et al.Antidepressant and antipsychotic side-effects and personalised prescribing: a systematic review and digital tool development.Lancet Psychiatry. 2023;10(11):860-876. doi:10.1016/s2215-0366(23)00262-6
Duffy L, Clarke CS, Lewis G, et al.Antidepressant medication to prevent depression relapse in primary care: the ANTLER RCT. Health Technol Assess. 2021;25(69):1-62. doi:10.3310/hta25690
Henssler J, Heinz A, Brandt L, Bschor T.Antidepressant withdrawal and rebound phenomena: a systematic review.Dtsch Arztebl Int. 2019;116(20):355-361. doi:10.3238/arztebl.2019.0355
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