How quickly do antidepressants work?
Most treatment guidelines suggest that antidepressants may take many weeks to work. It is argued that even if the current treatment seems ineffective, it should be persisted with for several weeks or even months. The Mood Disorders Unit interprets the evidence differently.
If medication is likely to be effective, evidence of at least some improvement should appear in the first ten days or so, whether it is an improvement in mood, sleep, or other features. For melancholic and psychotic depression, the rate of improvement is generally slower (but relatively constant). It may, in fact, appear painfully slow.
If no improvement is noted in the first two weeks after commencing an antidepressant, the dose of that drug may need to be increased, a change to another class of antidepressant may be required, or ‘augmenting’ strategies (the addition of quite differing drugs) may need to be introduced. Unfortunately, when changing from one drug to another, days to weeks may pass before success can be established. It might also be the case that non-drug strategies will be more effective in bringing the depression to an end.
Augmentation of antidepressant drugs
The effectiveness of some antidepressants can be increased by the use of adjunctive or augmentation drugs, for example, thyroid hormones or lithium.
There is increasing evidence to suggest that the new ‘atypical’ antipsychotic drugs may also have augmenting effects on antidepressants, often working rapidly and also being able to be ceased rapidly in many instances. While not investigated formally, the benefits of such augmenting drugs may only be relevant to melancholic and psychotic depression.
SSRI Pregnancy Concerns
SSRIs (antidepressants) have had somewhat of a panacea status with physicians prescribing the meds for all sorts of off label usage, particularly during the boom of the drugs existence over the past half decade. However, there has been a steady reporting of concerns related to the drugs as time progresses. Most people have heard about the adolescent suicide risk associated with the medication, and a new study is reporting that mothers taking the drugs put their newborns at risk for being under-weight and having respiratory problems.
”There was a significantly greater incidence of respiratory distress (13.9% vs. 7.8%) and longer hospital stays for infants born to depressed mothers on SSRIs than those born to untreated depressed mothers, the team reports in the Archives of General Psychiatry.”
Obviously, people should consult with their psychiatrists or health care providers for specific treatment information. I think the overall effect of some of these stories is going to be that people are more cautious about taking the drugs, and asking more pointed questions about their treatment.
What to Do About Antidepressants If You Are Nursing
There is no evidence to support fears that taking an antidepressant while nursing I harmful to the infant. Dr. Cynthia Neill Epperson of Yale University is one of the many researchers who have put this to the test. She recruited infants of depressed mothers, some breast-fed and others not, and then measured the level of antidepressant (in her work, Zoloft, which targets serotonin) and of serotonin in the infants’ blood. Reporting on her work, Epperson states that she detected no Zoloft in their bloodstreams and that there was no change in the level of serotonin in most of the infants. She concluded, with the scientist’s reserve, that “it does not appear that the administration of Zoloft in breast-feeding women is likely to have a physiologic effect on their children.”
Many depressed women derive much-needed joy from breast-feeding and become even more upset when deprived of the opportunity. Physicians who still caution against combining antidepressants with feeding except when the illness is severe recommend substituting a bottle once or twice a day to further reduce any possible risk. As always with depression, each sufferer should take into consideration all the known facts and with the of her doctor make an informed decision. What is right for one person may be wrong for another.
Zoloft withdrawal and depression
Zoloft is a member of the Selective Serotonin Reuptake Inhibitor family, which increases serotonin levels in the synapse by blocking serotonin reuptake into brain cells. Zoloft is a drug that was released by the Pfizer corporation in 1991 which aimed at fighting depression. The FDA approved Zoloft in October of 1997.
Depression Medication
Antidepressants or depression medication are drugs specially designed to overcome the problems in brain chemistry that cause depression.
Antidepressants are much more specific than painkillers. The SSRI drugs (marketed as Prozac, Seroxat, Lustral, etc) work specially to raise the levels of serotonin in the brain. Others raise the levels of noradrenalin. Lack of these mood-enhancing substances can cause depression. Raising their levels, a process that usually takes about 10 days, is usually very helpful.
There are side effects but they are often mild, short-lived and pale into insignificance as the depression improves.