Mental illness is more common than you think – 1 in 5 Canadians in any given year will personally experience a mental health problem. Unfortunately, almost half of those who feel they have symptoms of depression or anxiety do not seek medical help due to the stigma associated with mental illness and the surrounding myths with antidepressants. Here is a list of common questions we receive about antidepressants:
1) When will it start working?
Antidepressants generally take about 4 to 6 weeks to notice any improvement in mood. Some people might respond earlier at the 2 to 3 week mark. During the initial weeks, we are just looking to see if you tolerate the medication since side-effects may occur earlier.
2) What dose should I be on?
Antidepressants have a wide dosing range and there is no “one size fits all” dose. In general, these medications are started at a low dose and slowly increased which minimizes the risk of side-effects. By using this “start low and go slow” approach, we are trying to find the right dose that is most effective with the least amount of side-effects. More recently, genetic testing is now available to see how people metabolize certain antidepressants. This may help find the right drug and the right dose making therapy more individualized.
3) What side-effects can I expect?
Side-effects of antidepressants usually appear first before noticing any benefit which may be discouraging for some people. Rest assured that many side-effects are temporary and may go away with time if you’re able to tolerate them. Each antidepressant has a different side-effect profile so it’s important to review these with your pharmacist and discuss which ones you’re able to put up with and which ones are causing too much distress. If one antidepressant is causing significant side-effects then a switch to a different antidepressant may help.
4) Can I stop my antidepressant?
It’s never a good idea to suddenly stop your antidepressant without checking with your doctor or pharmacist first. This is because abruptly stopping an antidepressant may cause your anxiety or depression to return and may also cause significant withdrawal symptoms. Withdrawal symptoms are not dangerous but are extremely uncomfortable and may include: feeling irritable, trouble sleeping, shakiness or tremors, sweating, diarrhea, flu-like symptoms and “brain zaps” or shock-like symptoms. Withdrawal symptoms are more severe with certain antidepressants like Paxil (paroxetine) or Effexor (venlafaxine) and more common if you were taking your antidepressant for a long time or if you’re taking a high dose. To avoid withdrawal symptoms, it is best to come up with a plan on how to slowly reduce the dosage of your antidepressant with your doctor or pharmacist. This is called tapering or weaning off your antidepressant.
5) How long do I stay on an antidepressant?
This is a difficult question because the answer varies from individual to individual. For some people with severe symptoms and frequent relapses, they may benefit from staying on an antidepressant for many years. For others with less severe symptoms, a minimum of at least 9 months is generally recommended. Stopping antidepressants too soon increases the risk of having relapses in depression or anxiety.
Want to learn more? Feel free to call or drop by Apothecare Pharmacy.
Fast Facts about Mental Illness. Canadian Mental Health Association https://cmha.ca/about-cmha/fast-facts-about-mental-illness (Accessed November 30, 2018)
https://www.pillcheck.ca/ (Accessed November 30, 2018)
Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the management of Adults with Major Depressive Disorder: Section 3. Pharmacological Treatments. The Canadian Journal of Psychiatry 2016; 61 (9): 540-560.