Antidepressants are a type of medicine used to treat clinical depression. They can also be used to treat a number of other conditions, including, Obsessive Compulsive Disorder (OCD), Generalised Anxiety Disorder (GAD), and Post-Traumatic Stress Disorder (PTSD). Antidepressants are also sometimes used to treat people with long-term (chronic) pain.
The main use for antidepressants is treating clinical depression and anxiety in adolescents and adults. They're also used for other mental health conditions and treatment of long-term pain. In most cases, adults with moderate to severe depression are given antidepressants as a first form of treatment. They're often prescribed along with a talking therapy such as cognitive behavioural therapy (CBT). CBT is a type of therapy that uses a problem-solving approach to help improve thought, mood and behaviour.
Antidepressants are not always recommended for treating mild depression because research has found limited effectiveness. However, antidepressants are sometimes prescribed for a few months for mild depression to see if you experience any improvement in your symptoms. If you do not see any benefits in this time, the medicine will be slowly withdrawn.
Initially, a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI) is usually prescribed. If your symptoms have not improved after about 4 weeks, an alternative antidepressant may be recommended or your dose may be increased.
Many antidepressants can be prescribed by your GP, but some types can only be used under the supervision of a mental health professional. If the depression does not respond to antidepressants alone, other treatments, such as CBT, may also be used to help achieve better results. They may also give higher doses of the medicine.
how antidepressants work
It's not known exactly how antidepressants work. It's thought they work by increasing levels of chemicals in the brain called neurotransmitters. Certain neurotransmitters, such as serotonin and noradrenaline, are linked to mood and emotion. Neurotransmitters may also affect pain signals sent by nerves, which may explain why some antidepressants can help relieve long-term pain. While antidepressants can treat the symptoms of depression, they do not always address its causes.
doses and duration of treatment
Antidepressants are usually taken in tablet form. When they're prescribed, you'll start on the lowest possible dose thought necessary to improve your symptoms. Antidepressants usually need to be taken for 2 or 3 weeks (without missing a dose) before the benefit starts to be felt, though this varies. It's important not to stop taking them if you get some mild side effects early on, as these effects usually wear off quickly.
If you take an antidepressant for 4 weeks without feeling any benefit, speak to your GP or mental health specialist. They may recommend increasing your dose or trying a different medicine. A course of treatment usually lasts at least 6 months. Some people with recurrent depression may be advised to take them indefinitely.
When prescribing antidepressants, your GP usually selects the lowest possible dose thought necessary to improve your symptoms. This approach is intended to reduce the risk of side effects. If this dose does not work, it can be gradually increased.
Antidepressants are usually taken in tablet form, and can take around 7-21 days before you begin to notice the effects of antidepressants, though this can vary with each patient. Contact your doctor if you have not noticed any improvement after 4 weeks, as they may recommend increasing your dose or trying a different antidepressant.
It's usually recommended that a course of antidepressants lasts at least 6 months, to prevent your condition recurring when you stop. Some people with recurrent illness are advised to carry on taking medicine indefinitely. The recommended course of treatment largely depends on weighing up the benefits of the medicine against the side effects. If your illness is severe and the medicine is effective, treatment will often be continued. If your illness is mild and the medicine does not help and causes side effects, continued treatment will not be recommended.
Listed below are just some options of 'types of antidepressants'. The ones listed are most commonly prescribed. Please visit NHS for further information.
missed or extra doses
It's important not to miss any of your doses, as this could make your treatment less effective. You may also get withdrawal symptoms as a result of missing a dose of the medicine. If you do miss 1 of your doses, take it as soon as you remember, unless it's almost time to take your next dose. In this case, you should just skip the missed dose. Do not take a double dose to "make up" for the 1 you missed.
If you take more tablets than prescribed, contact your GP as soon as possible for advice. If this is not possible, contact your local out of hours service, or call NHS 111. Taking a double dose is unlikely to be harmful, but you should only do so if advised by a medical professional.
stopping antidepressants
Talk to your doctor before you stop taking antidepressants. It's important that you do not stop taking antidepressants suddenly. Once you're ready to come off antidepressants, your doctor will probably recommend reducing your dose gradually over several weeks - or longer, if you have been taking them for a long time.
Possible withdrawal symptoms can include:
- restlessness and trouble sleeping
- unsteadiness
- sweating
- stomach problems
- feeling as if there's an electric shock in your head
- feeling irritable, anxious or confused
Withdrawal symptoms are often mild and get better on their own. However, some people have withdrawal symptoms that are severe and last for several months or more. Coming off antidepressants too soon can cause your condition to return. Stopping before you have been taking them for 4 weeks may mean the medicine has not had a chance to work.
