How Long Do Antidepressants Take to Work?

The timing NIMH gives

The National Institute of Mental Health (NIMH) says antidepressants take time, usually 4 to 8 weeks, to work. It adds that problems with sleep, appetite and concentration often improve before mood lifts, and that giving a medicine a chance to work is important before deciding whether it is right for you.

That can be a hard wait when you already feel low, and it is fair to find it frustrating. Knowing the usual timing may help you avoid reading the first few weeks as failure. A quieter early change, like falling asleep more easily, can be worth writing down and sharing at your next visit.

What to keep track of

Your prescriber can only respond to what they know, so simple notes help. NIMH also suggests that people prepare for visits by listing their questions and describing when symptoms started, how severe they are and how often they happen. A few lines a week is plenty.

• Sleep: when you fall asleep, whether you wake early, and how rested you feel.
• Appetite and energy: any change, in either direction.
• Concentration: whether reading, work or conversations feel easier or harder.
• Mood and interest: moments that felt different, even small ones.
• Side effects: what you noticed, and whether it is easing.

Why the early weeks need extra care

Waiting does not mean doing nothing. NIMH says children, teenagers and young adults under 25 may in some cases have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. It says the FDA advises that people of all ages taking antidepressants be watched closely during those first weeks.

Antidepressant labels carry this as a boxed warning. The sertraline Medication Guide also asks people to keep follow-up visits and to call between visits if they are worried. If you are in crisis, call or text 988, or call 911. Locascio Wellness does not provide emergency services.

Why stopping suddenly is a problem

NIMH says people should not stop a prescribed medicine, even if they feel better, without help from a health care provider, because stopping too soon may cause unpleasant or harmful side effects. A provider can slowly and safely decrease the dose, which gives the body time to adjust. MedlinePlus adds that stopping too fast may make depression come back or make your condition worse.

FDA labels describe what can happen. The label for sertraline lists nausea, sweating, low mood, irritability, agitation, dizziness, sensations like electric shocks, tremor, anxiety, confusion and headache among reactions after serotonin medicines are stopped, particularly when stopped abruptly. The label for venlafaxine says that symptoms after reducing or stopping can sometimes be severe and long-lasting.

If time passes and little has changed

It is common for a first medicine not to be the final answer. NIMH says people respond to medicines in different ways and that it may take several tries to find the one that is most effective with the fewest side effects. In some cases a medicine helps for a while and then symptoms return.

NIMH also says that treatment-resistant depression occurs when a person does not get better after trying at least two antidepressants, and that other options exist. Your prescriber can go through what comes next. Therapy is part of that picture too: depression therapy can be added alongside medicine for people in the states where our therapists see clients.

Checking in with us

A licensed psychiatrist on our team, a Doctor of Osteopathic Medicine with more than three decades of practice, offers online depression treatment by secure video for people physically located in Pennsylvania or New York during each visit. If you are already taking a medicine, ask us whether our psychiatrist can help using our medication care contact form, and talk with your current prescriber before changing anything in the meantime.

Our therapists do not prescribe. They see clients in Pennsylvania, West Virginia, Arizona, Colorado and Florida, not New York, so a New York reader would look elsewhere for therapy.