Depression is among the most common mental health conditions. But for most people, it’s entirely treatable. The American Psychiatric Association states that nearly 100% of patients experience at least some relief from symptoms, and 80% to 90% experience significant improvement.
Mild to moderate depression tends to respond well to therapy alone, while more severe cases usually require medication. A recent American Journal of Psychiatry study showed that combining the 2 treatments was often most effective for patients who failed to manage their depression with either treatment alone.
If you’ve just been diagnosed with depression, you likely have questions. So we spoke with the experts to find your answers. (And if you’re on medication, be sure to bring the Optum Perks prescription discount card with you to the pharmacy. You could save up to 80%.)
1. What are the most common medications used for depression, and how do they work?
Prozac® and Zoloft® are the medications you may have already heard of. These are selective serotonin reuptake inhibitors (SSRIs), the most prescribed class of medication for the treatment of depression. Common SSRIs include (click each drug name to access instant coupons):
As the name suggests, SSRIs increase levels of serotonin. This is a neurotransmitter, or brain chemical, that helps regulate mood, says Joy Alonzo, PharmD. She’s a clinical assistant professor of pharmacy practice at the Texas A&M Health Rangel College of Pharmacy in College Station.
A second class of antidepressant you may encounter is called serotonin and norepinephrine reuptake inhibitors (SNRIs). In addition to serotonin, these target the neurotransmitter norepinephrine. SNRIs may help relieve chronic pain, which makes them effective for patients who develop depression as a result of physical suffering. Examples of SNRIs include:
Other medications used for depression include:
- trazodone (Desyrel®)
- mirtazapine (Remeron®)
- bupropion hydrochloride (Wellbutrin®)
- aripiprazole (Abilify®)
These medications are generally used to target specific cases. Trazodone and mirtazapine, for instance, have sedating effects, meaning they make you sleepy. This can be useful if your depression is keeping you awake. Trazodone and mirtazapine may each be used on their own or prescribed alongside other medication to help with sleep.
Bupropion has an added benefit of helping people quit smoking, while aripiprazole is considered an antipsychotic medication. It’s usually used in combination with a more traditional antidepressant, such as an SSRI.
Alonzo says an older class of antidepressants, called tricyclics, are effective but aren’t often a first choice among doctors. They come with too many negative side effects. Examples of tricyclic antidepressants include:
2. How quickly do depression medications work?
SSRIs can take 4 to 6 weeks to fully kick in. But you may notice smaller improvements, such as more energy or less intense negative emotions, earlier.
SNRIs work a little faster. You’ll usually feel the full effect in 3 to 6 weeks. Trazodone and mirtazapine work right away for sleep, but they take 2 to 4 weeks for depression relief. Bupropion may take longer, maybe 6 to 8 weeks for full effect, and aripiprazole usually starts working within 72 hours.
Tricyclics, which are less commonly used, usually start working in a couple of weeks. They often reach full effect after about a month.
3. How will I know my medication is working?
“SSRIs are very effective, but you’ve got to have faith and give it some time,” says Alonzo. “It’s more the absence of feeling poorly at first versus feeling well.”
Your doctor should schedule a checkup with you within the first month or so of treatment to see how you’re doing. Hopefully you’ll find yourself better able to deal with stress. You should also be sleeping better as your depression improves.
If 4 to 6 weeks go by and you still aren’t feeling significant improvement, tell your doctor. You may need to have your medication adjusted. Do not abruptly stop taking your antidepressant medication. It’s important to taper the dose down to avoid symptoms of withdrawal.
Learn more about how to resolve serious sleep problems with our guide: “The Safest Way to Cure Insomnia.”
4. Are there side effects?
Yes, but they’re usually mild. With SSRIs and SNRIs, some patients report headaches, dry mouth, sleep trouble, sexual problems (inability to orgasm or poor sex drive) and more. Nausea and stomach upset are also common, but they tend to fade quickly. Bupropion can cause many of these same issues, but it is less likely to impact sexual function.
Each medication comes with its own side effects, so you should talk to your doctor about what to expect with your specific prescription. Mirtazapine increases appetite and can cause weight gain. (In some patients this is a good thing, since depression sometimes causes people to lose their appetite.)
Aripiprazole can cause headaches and nausea and may make you tired. Tricyclics can cause dizziness, constipation, dry mouth, urinary retention and heart complications in patients with pre-existing heart conditions.
