By Dr. David Woo - November 14, 2019

Many people who are taking antidepressants for major depressive disorder (MDD) struggle to understand whether their medications are working. Should you feel happy 24 hours a day, seven days a week? Is it normal to still feel depressed even if you’ve been taking antidepressants for a certain period? 

Antidepressants don’t produce the same results for everyone. The effects can vary from person to person, and it’s difficult to understand how and when you’ll see benefits from an antidepressant until you try it. 

When Should You Expect To Feel Results From Your Antidepressant?   

There are a variety of antidepressant medications available. Each one works by targeting certain neurochemicals in the brain and using a unique mechanism. For example, the most commonly prescribed antidepressants, called selective serotonin reuptake inhibitors (SSRIs), inhibit the body’s absorption of serotonin to increase serotonin levels in the brain. (1) Since different antidepressants relieve depressive symptoms using a unique mechanism, each type of antidepressant can take a different amount of time before someone sees its effects.

Antidepressants may start to work within as little as two weeks, but it can take several weeks (up to 14 weeks) before you start to see benefits from an antidepressant. (2) Many people can start to lose hope when they start taking antidepressants and expect to feel happy within a few days. But finding the right depression treatment takes time, and can be a trial and error process that you undergo with your doctor. If you don’t feel improvement in your symptoms after 6-8 weeks, your doctor may choose to change your dosage or switch you to a different antidepressant. 

You May Feel Side Effects Before You Feel the Benefits of an Antidepressant 

Many times, people will start to feel the side effects of an antidepressant before they start to feel relief from depressive symptoms. This is because side effects are typically felt the first few weeks of treatment, though they may be less common later on. (3) 

It’s normal to feel the side effects of an antidepressant. As your body adjusts to the medication, side effects may go away on their own. Some side effects may not go away, but it’s possible that they can be managed if your doctor adjusts your prescribed medication dosage. 

Common side effects of antidepressants can include: 

• Increased appetite
• Weight gain
• Loss of sexual desire and/or sexual dysfunction 
• Constipation
• Agitation and irritability (4)

If the side effects of your antidepressant are unpleasant, never increase or decrease your dosage on your own or stop taking your antidepressant without talking to your doctor.

What if You’ve Tried Multiple Antidepressants With No Relief?

If you feel frustrated because you haven’t found relief from depressive symptoms with antidepressants, or if your symptoms have worsened while taking antidepressants, you’re not alone: it is estimated that roughly one-third of patients diagnosed with depression are resistant to standard treatments of antidepressants and psychotherapy (talk therapy). This is referred to as treatment-resistant depression. (5) 

If you have tried multiple antidepressants and have not found relief of depressive symptoms, or if you feel worse, talk to your doctor about treatment-resistant depression.   

Are There Alternative Treatments That Can Help Relieve Depression Symptoms?

Transcranial magnetic stimulation (TMS) is approved by the FDA to treat patients with treatment-resistant depression. (6) TMS works by stimulating cells in the regions of the brain known to be associated with depression using magnetic pulses. TMS is a one-course treatment that lasts approximately nine weeks—six weeks of treatment and a three week taper period.

The time it takes for someone to notice the effects of TMS varies from patient to patient because several factors can contribute to how quickly someone feels the effects of TMS. Some patients start to feel improvement in depressive symptoms after two weeks of TMS therapy, while some patients may not feel improvement in their symptoms until the fourth or fifth week of TMS therapy. Although different people may feel the effects of TMS at different times, TMS provides long-lasting effects. The effects of TMS have been shown to provide relief from depressive symptoms one year after the depression treatment period. (7) Learn more about TMS therapy success rates.

Transcranial Magnetic Stimulation at Madison Avenue TMS & Psychiatry in NYC

If you’d like to learn more about TMS in NYC and how it can help patients with treatment-resistant depression, contact our office. You can also learn more about TMS therapy costs.

Resources:

1. Selective serotonin reuptake inhibitors (SSRIs). Mayo Clinic. Published September 17, 2019. Link. Accessed October 13, 2019.

2. Machado-Vieira R, Baumann J, Wheeler-Castillo C, Latov D, Henter ID, Salvadore G, and Zarate CA. The timing of antidepressant effects: A comparison of diverse pharmacological and somatic treatments. Pharmaceuticals. January 2010 6;3(1):19-41. Link. Accessed October 13, 2019.

3. Depression: How effective are antidepressants? InformedHealth.org. Published January 28, 2015. Updated January 12, 2017. Link. Accessed October 13, 2019.

4. Allen A. Coping with side effects of depression treatment. WebMD. Published March 09, 2011. Link. Accessed October 13, 2019.

5. Ionescu DF, Rosenbaum JF, and Alpert JE. Pharmacological approaches to the challenge of treatment-resistant depression. Dialogues in Clinical Neuroscience. 2015 Jun; 17(2): 111–126. Link. Accessed October 13, 2019. 

6. Horvath JC, Mathews J, Demitrack MA, and Pascual-Leone A. The NeuroStar TMS device: conducting the FDA approved protocol for treatment of depression. Journal of Visualized Experiments. November 2010;(45). pii: 2345. Link. Accessed October 13, 2019.

7. Dunner DL, Aaronson ST, Sackeim HA, et al. A multisite, naturalistic, observational study of transcranial magnetic stimulation for patients with pharmacoresistant major depressive disorder: Durability of benefit over a 1-year follow-up period. Journal of Clinical Psychiatry. 2014;75(12):1394-401. Link. Accessed October 13, 2019.

Dr. David Woo

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.