PHASE 1: Find an antidepressant that works

Antidepressants are designed to adjust your brain chemistry and promote healthy patterns of thinking. After taking your antidepressant for around 2-12 weeks, you should begin to see improvements in your well-being. 

If you don’t feel any better after 8 weeks, be sure to discuss how you feel with your doctor. Your doctor might adjust your treatment plan (e.g. increase dosage, add another medication) or have you switch to a new medication. If you switch medications, you would gradually taper off your current medication(s) and restart your journey at the beginning of Phase I. Don’t worry if this happens — these adjustments mean that you’re one step closer to finding a medication that works for you. (more on how to avoid these pitfalls later)

If your prescription causes negative side effects, you will likely experience them before you notice any positive changes. These side effects are usually temporary and go away after several weeks. Mild side effects are to be expected. However, if your side effects are more persistent (meaning lasting several weeks), talk to your doctor about modifying your medication plan or switching antidepressants altogether.If you are seeing improvements and aren’t struggling with persistent side effects, then you can expect to continue with your pre-existing treatment plan, and proceed to Phase II.

PHASE 2: Stabilize on the medication

Many people believe that they can stop taking medication as soon as they start to feel better, but that can be risky. Doctors typically recommend staying on an antidepressant for 6-12 months — and sometimes longer — after you start experiencing improvements. It’s important for you to let yourself stabilize on your medication to experience long-term benefit. 

Why? Patients with depression often experience relapses. If you stop too soon, you are more likely to experience a mental health relapse in the near-term.

PHASE 3A: Taper off the antidepressant

When you and your doctor decide that it’s time to taper off medication, your doctor will proceed by slowly lowering your medication dosage.

It’s important to taper off of medication instead of stopping cold turkey; stopping too quickly can lead to uncomfortable withdrawal symptoms such as fatigue, irritability, and more as your body readjusts. These symptoms usually go away within a few weeks (don’t worry, the existence of withdrawal symptoms doesn’t mean that antidepressants are addictive; it just takes time to wean off of antidepressants safely).

The length of this taper-off period is different for each person, taking anywhere from a couple of weeks to several months. The length depends on what medication you’re taking, the dosage, how long you’ve used medications, and the severity of your mental health condition. As always, it’s best to consult your doctor regularly when making decisions about how to adjust your treatment.

PHASE 3B: Sustained wellness with medication

The right amount of time to be on an  antidepressant is different for everyone. If you and your doctor agree that stopping medication isn’t the right clinical decision, you can continue with your treatment plan and work with your doctor to ensure you’re getting the best care for your unique situation.

Avoiding Pitfalls

Now that you understand the three phases of taking an antidepressant, there are a few things you should know about improving your chances of finding the optimal medication. 

• Genetic testing: Our genes affect how we process medication. A genetic test (also called a pharmacogenomic test) can help doctors see which medications might be inappropriate or which medications may cause negative side effects at the standard starting dosages. This makes it easier for them to narrow in on better options for you. 
• Expert opinion: Unlike primary care providers, psychiatrists specialize in mental health conditions and medication. Having a psychiatrist’s expertise in your corner can ensure that you can more quickly find the right treatment for you.

Care management: The road to better mental health is rarely smooth, but having emotional as well as medication support can make this process much easier. That’s why a membership with Prairie includes a Care Coordinator, who is available to answer questions, check in with you, and coordinate care with your other providers. Research shows that having this kind of multifaceted approach to mental health care leads to better outcomes.

Do’s and don’ts with antidepressants

There are several things within your control to make the process go more smoothly. Here are some do’s and don’ts to keep in mind: 

Overall, taking an antidepressant is not the final stop in your mental health journey, but a road to travel in its own right, and this road is different for everyone. It will take some time to see improvements, but as long as you are committed to working on yourself and working with your mental healthcare provider, you can get better. 

It can take a long time to find an optimal medication regimen and have it work, but being patient and trusting your doctor can help you immensely on your mental health journey. An effective medication works hand-in-hand with healthy habits, therapy, and constructive thinking to help you get and stay better. The right medication can truly make a difference; by understanding what the process is like, you have the power to make informed decisions about how to best support your mental healthcare. 

With Prairie’s PrecisionStart program, you have the option to get a genetic test during your first month to help find the right medication regimen faster, then regular psychiatry visits and ongoing support over text every step of the way. We’re here to support you if you have any questions about treatment or if you would like to explore how medication could help.