Signs that your antidepressants aren’t working

Antidepressants are a type of medication that is FDA-approved for a range of mental health conditions including depression, obsessive-compulsive disorder, social phobia, panic disorder, generalized anxiety disorder, and post-traumatic stress disorder. ^[1]

Whilst antidepressants will not cure these conditions, they can aid in the management of symptoms, typically by regulating the amount of serotonin in the brain. ^[1]

However, you may be taking a specific antidepressant and feel that it isn’t working for you. This may happen whether you started your course 1-3 months ago, or if you are a long-term user of a medication that proved effective in the past.

Why do I feel like my antidepressants aren’t working?

You may need to try a new antidepressant. A 2016 study showed that two-thirds of participants did not respond to the first antidepressant course they were prescribed. ^[2]

Alternatively, you may be experiencing tachyphylaxis, a condition marked by you stopping responding to a medication that was previously effective. ^[3]

There may be several reasons why your antidepressants aren’t working, but it is important for you to recognize the signs.

6 signs your antidepressants aren’t working

1. No change in symptoms after 12 weeks

Studies show if there is no discernible alleviation of symptoms after 8-12 weeks of treatment, a prescription should be altered. ^[4] Most experts agree that a class switch is justified if a patient has not experienced relief from a fully prescribed first course. ^[4]

2. Persistent or worsening symptoms

If your depression, or other mental health condition, appears to be worsening at any stage during your antidepressant course then you should inform your doctor as soon as possible.

3. Sleep Disturbances

While some antidepressants can cause short-term disruption to sleep patterns, this side effect should lessen after a few weeks. ^[4] If sleep disruptions are common, it may be a sign that the antidepressant is not working.

4. Showing signs of serotonin syndrome

Although quite rare, your antidepressants may inadvertently react with another substance you’ve taken causing your body to act out. You may feel feverish, ache constantly, sweat profusely, feel agitated, nauseous, restless, or experience muscle spasms. ^[5]

Symptoms tend to manifest rapidly with nearly all people showing signs of serotonin syndrome within 24 hours of exposure to an antidepressant. ^[4] Consult your doctor immediately upon feeling any of these symptoms as serotonin syndrome can be potentially life-threatening if left unchecked. ^[5]

5. Emotional blunting

Some people report neither feeling happy nor sad – but rather numb or flat – following antidepressant use. Known as emotional blunting, this is one of the most common side effects that results in stopping antidepressant treatment. ^[6] Upon consultation with your doctor, they will typically reduce your dose or switch you to a different antidepressant if the benefits are thought to outweigh the risks. ^[6]

6. The side effects are overwhelming

Side effects are an extremely common aspect of taking antidepressants. ^[1] However, there may come a time when you decide they are doing you more harm than good, rendering your antidepressants ineffective. Side effects can include, but are not limited to: diarrhea, nausea, an inability to focus, appetite suppression, overwhelming fatigue, and a pervasive lack of motivation.

Consult your doctor before altering your course of antidepressants. Together you can decide whether to try a new antidepressant and taper you off your current course to minimize withdrawal symptoms.

Reasons why your antidepressants aren’t working

There are several reasons your antidepressants may not work, including:

You need a higher dose

Whilst starting on a lower dose may be a viable choice to assist in managing or avoiding side effects, you may need a higher dose of antidepressants for them to be effective.

The pace at which you should increase your dosage of antidepressants will vary on a case-by-case basis, so it’s essential you consult your healthcare provider to determine the optimum dosage for you.

You may not have taken it for long enough

Antidepressants can take up to 8-12 weeks to work effectively ^[4], so it may be that more time is required to see improvements.

You might be taking the wrong antidepressant

There are five different classes of antidepressants and multiple variants within these classes. The right medication for one person may not be effective for someone else. Sometimes, finding the right antidepressant for you is best accomplished through trial and error. Consult your doctor before stopping or starting any course of antidepressants.

You may be taking an alternate medication

Some medications can interact with one another preventing each other from working effectively or, more gravely, causing serotonin syndrome.

For optimum results, it is recommended you ensure your healthcare provider has been informed of all medications you are taking. They can use this knowledge to prescribe you the antidepressant with the fewest interactions.

You may need supplementary treatment

Sometimes medication alone may not be the most effective form of treatment. Therapy combined with medication is considered the front-line treatment for depression and combining the two approaches may help improve symptoms.