What to consider when your doctor prescribes an antidepressant

November 12, 2019 in Disease Management  •  By Miles Varn, MD

If your primary care physician or psychiatrist has recommended that you take an antidepressant, asking some key questions can help you better understand what to expect and help your doctor choose the medication that’s most appropriate for you. It’s also important to remember that not all antidepressant medications work well for all patients, so it may take time for you and your doctor to find the right medication and dosage. Although there are genetic tests that may help determine how efficiently your body will process certain types of antidepressants, a study published in The American Journal of Clinical Psychology concluded that while the data is promising, it’s not robust enough to support the recommendation of widespread use of these tests at this point in time.

What to discuss with your doctor

The first question you may want to ask is whether an antidepressant is needed. If your depression or anxiety do not significantly interfere with your ability to do what you need to do day-to-day, you may want to try other approaches first. Ask your doctor if he or she would recommend talk therapy or trying lifestyle changes first, such as stopping using alcohol or recreational drugs, being more physically active, or improving your sleep habits and quality. If these approaches don’t provide relief from your symptoms, you can then add an antidepressant to your treatment plan.

If you and your doctor decide you should take an antidepressant, tell your doctor if you’ve taken these medications before and which medications were effective and which were not. You should also share any side effects you experienced.

You should outline your complete mental health history for your doctor, including how frequently you have experienced symptoms of depression or anxiety, how long these episodes lasted, how severe symptoms were, and what types of treatment you underwent. It’s also important to tell your doctor about any other health problems or chronic conditions you’re living with. The symptoms of many physical health problems can mimic anxiety and depression. If you have no personal or family history of depression or anxiety and your symptoms start suddenly, ask your doctor to check for underlying health problems that may be causing your mental health symptoms.

Antidepressants can cause a range of side effects, including weight gain, lowered sex drive and erectile dysfunction, nausea, fatigue, and sleep problems. If you’re concerned about the potential side effects of the medication you’ve been prescribed, talk frankly with your doctor about your concerns. Your doctor may recommend a different medication based on side effects you wish to avoid. For example, bupropion (brand name Wellbutrin) is associated with a lower incidence of sexual side effects and weight gain and may be a good choice for someone who’s worried about these potential side effects.

You should also talk with your doctor to find out how long he or she expects you to continue taking the medication and how long it may take before you experience a benefit from the medication. Depending on which medication your doctor prescribes and how severe your depression is it can take a few weeks to a few months for you to notice that the medication is helping control your symptoms.