Depression relief from an antidepressant usually takes two to 12 weeks to set in, with a peak at six to eight weeks. “So if you feel different immediately after starting a depression treatment, it’s either a side effect of the depression medication or a placebo effect,” Hullett says.
What are antidepressants?
ANTIDEPRESSANTS are a special group of psychotropic drugs that never and under no circumstances cause any drug dependence (this risk exists only if the tranquilizers are misused), or inhibition or any reduction in clarity of consciousness, memory, attention, mental activity ( these negative effects are possible only when using neuroleptics ).
The overwhelming majority of psycho-emotional disorders with which they are referred to a psychotherapist are successfully treated with only one correctly chosen antidepressant. The cause of failures, as practice shows, is not the drug itself, but the mistakes made during its appointment.
What is a new generation of antidepressants?
Antidepressants of the new generation, or serotonin-selective antidepressants, belong to the group of SSRIs – selective serotonin reuptake inhibitors.
They are ideally tolerated, do not have cardio, nephron and hepatotoxic effects, i.e., they do not adversely affect the liver, kidneys, heart and other organs, many of them are widely used in childhood and old age, with concomitant physical diseases, in the post-infarction and post-stroke periods, in combination with other therapeutic agents.
In Western countries, modern antidepressants are increasingly being positioned as drugs that improve the quality of life, because they allow you to maintain a long-term and stable sense of personal comfort, resistance to stress, and a positive life attitude.
How does an antidepressant work?
Simply put, antidepressant effect manifested by the fact that the brain leaves the stressful mode of functioning – anxiety decreases, internal tension is relieved, mood improves, irritability and nervousness disappear, night sleep normalizes, the autonomic nervous system stabilizes – for example, palpitations, dizziness, headache, blood pressure fluctuations, emotionally stop due to disorders of the stomach, intestines, etc.
It is achieved by restoring the proper work of brain neurotransmitters – serotonin, noradrenaline, dopamine, and other protein molecules, providing the transmission of electrical impulses between neurons. It takes time, so the effect of modern antidepressants develops very gradually, manifesting itself not earlier than 3-5 weeks from the start of the drug.
The full final effect is highly dependent on
1) the correct choice of drug,
2) the correct selection of the dosage,
3) the correctly determined duration of treatment;
4) correct cancellation. Violation of even one of the points can lead to the ineffectiveness of the whole treatment, and such cases are widely discussed by patients who unreasonably consider the drug to be the cause of the failure.
How to take an antidepressant?
Treatment with antidepressants consists of two main stages:
1) the main one, during which all symptoms of depression, anxious neurosis or autonomic dysfunction must pass (the use of an antidepressant does not at all mean that the patient’s problem is or only depression );
2) supporting (or control ), during which it is necessary to continue the treatment in the complete absence of symptoms and the patient’s ideal state of health. Moreover, it is only under this condition that the maintenance treatment makes sense. Otherwise, the choice of the drug and its dosage must be reviewed.
Thus, if the full effect is absent at the first stage of treatment, it is senseless and wrong to continue it in a supportive mode, as this may cause a decrease in the body’s susceptibility to the drug (resistance, tolerance) and its further inefficiency.
How long does it take to take an antidepressant?
With the right approach, drawing up the final treatment regimen usually requires only 2-3 consultations of a psychotherapist in the first 2-3 months of treatment. The main period of treatment to eliminate all symptoms of the psycho-emotional disorder usually takes 2-5 months.
After this, therapy in no case stops and proceeds to a supporting stage, which, in the absence of external aggravating factors (constant or new unforeseen emotional stresses, endocrine disorders, physical diseases, etc.) is usually 6-12 months, much rarer, but demanding cases – can last for years.
It is appropriate to compare this situation, for example, with the treatment of hypertension, when long-term or even regular intake of a drug that normalizes blood pressure is necessary.
No one would even think that the hypertensive person was “addicted” or “used” to a drug that allows him to live with normal blood pressure, everyone understands that long-term treatment is necessary based on the characteristics of the disease. However, even this is an exaggeration: in the overwhelming majority of cases, the course of taking an antidepressant is only long, not lifelong.
I emphasize once again that a long course of treatment with an antidepressant makes sense not in anticipation of the result, but after it has been achieved, i.e., It is carried out with the ideal state of health of the patient.
When can I stop an antidepressant?
Termination of treatment with an antidepressant, as well as its beginning, must be agreed with the attending physician and is not so much medical (especially, the date of cancellation is not determined by any calendar period), but for social and psychological reasons, i.e. when positive changes stably manifest themselves not only in the patient’s state of health but also have a positive effect on the events of his life, for example, they will lead to a real way out of the negative situation in which neurosis occurred.
How to cancel an antidepressant?
Cancellation of an antidepressant should be made gradually according to the scheme proposed by the attending physician and should not be abrupt or sudden, but also overly prolonged.
The higher the dosage of the drug, the longer the cancellation takes place, but in any case, this period takes no more than a month. Otherwise, the situation described in section 6 of the section “Antidepressant withdrawal syndrome” is created.
During treatment, undesirable breaks are undesirable (there should always be a stock of 1-2 packages at home), since 3-4 days after the sudden discontinuation of the antidepressant is possible, there is no harmless, but subjectively unpleasant withdrawal syndrome, caused not by addiction or addiction to the drug, but by “unexpected” for the brain receptors, the cessation of its entry into the bloodstream , which often also happens with abrupt cancellation of others drugs that are not psychotropic.
In case of an unforeseen interruption in the intake of an antidepressant, all manifestations of withdrawal syndrome disappear in the coming hours after the resumption of its intake, and if the intake does not resume, they completely disappear within 5-10 days.
With well-planned cancellation of an antidepressant, whatever the duration of its reception, the withdrawal syndrome, if it does, does not cause any serious inconvenience. Some antidepressants (for example, fluoxetine, vortioxetine) generally cannot cause withdrawal syndrome under any circumstances.
What happens after you stop taking an antidepressant?
With proper treatment after discontinuation of the antidepressant in the foreseeable future, the effect that was achieved on the main and fixed at the supporting stages of treatment is preserved.
Antidepressant withdrawal syndrome
The “consequences” of taking antidepressants widely discussed by the people (most often they are talking about allegedly sitting on a drug or not being able to stop taking it because of the severe “withdrawal syndrome”) can scare the patient in the following cases:
1) the drug and/or its dosage were chosen incorrectly, as a result, the full therapeutic effect was not achieved at all, only the masking of the symptoms of psycho-emotional disorder occurred, the improvement was partial, the patient’s state of health became “somewhat easier”, and did not change drastically and qualitatively;
2) maintenance treatment was carried out with an incomplete therapeutic effect, the patient was not aware of what result should be achieved, and balanced between poor and “acceptable” well-being, from which, after discontinuation of the drug, well-being, naturally, became persistently bad again;
3) maintenance treatment was not carried out at all; the antidepressant was canceled immediately after the effect was achieved, i.e., clearly premature;
4) the patient was not warned by the doctor about possible temporary discomfort lasting for 5-10 days (slight nausea, dizziness, lethargy, headache, sleep disturbance) when the antidepressant was canceled, taking these sensations as a renewed neurosis.
5) the abolition of the drug was made roughly, abruptly, suddenly, without consulting the doctor, as a result of which the patient experienced severe withdrawal syndrome, having taken his symptoms for the resumption of neurosis, or even deciding that he was “used”, “hooked on the drug” and “breaking”;
6) drug withdrawal was prolonged, was made unnecessarily long: faced with the first manifestations of withdrawal syndrome with a decrease in dosage, the patient was frightened and stopped its further reduction (for example, taking “quarters”, “half” tablets per day or every other day, or depending on state of health for a long time), thereby keeping himself artificially in a state of withdrawal, not allowing him to end, while, as a rule, complaining about the extremely difficult “withdrawing” from the drug;In some cases, this situation can last for months.