I am not a doctor. I probably know more about psychiatric medications than most non-doctors, but I’m not qualified to give medical advice. Having said that, here is some of what I know about medications for Depression:
- They are effective for moderate, severe and chronic depression, but probably not for mild cases.
- All medications have side-effects. Antidepressant side-effects include sexual side-effects, nausea, weight gain, fatigue. drowsiness, insomnia, dry mouth, blurred vision and constipation.
- Antidepressants take four to six weeks to start to show therapeutic effects, though most of the side-effects show up in the first week.
Effectiveness varies. Without antidepressants, about 20 to 40 out of 100 people who took a placebo noticed an improvement in their symptoms within six to eight weeks; that improved to 40 to 60 out of 100 people with antidepressants.In other words, antidepressants improved symptoms in about 20 more people out of 100. Notice that I said “noticed an improvement in their symptoms.” That is not the same as “cure” or even “significant reduction in symptoms.” For most of this research, any improvement, even one less symptom, was enough to score a “success.”- Cognitive behavioral therapy and second-generation antidepressants (SSRIs like Prozac or Luvox) have been shown to be about equally effective as treatments for major depression.
- A combination of cognitive behavior therapy and antidepressant medication appears to be more effective than medication alone.
I’ve seen antidepressant medications help people dramatically; but I’ve also seen them make no difference whatsoever. I have taken antidepressants myself, and have not noticed any change; but the research suggests I was not a good candidate for medication because my Depression was mild (see above).
If you don’t have a doctor you trust, you need to find one, because trust is going to be important. The prescriber needs to take the time to get to no you, and to monitor the effectiveness of anything she or he prescribes. He should be very clear on documenting your symptoms, typically using something like the PQH-9 scale (You might want to complete one and take it with you to your appointment).
She or he should want to see you again in about four to six weeks; at which time a decision will need to be made as to whether to discontinue the medication, increase the dose, or even add a second medication. These are all reasonable alternatives.