How Long Do Antidepressants Take to Work? Improve the Wait by Setting Accurate Expectations

Antidepressants are often a vital part of the strategy for treating depression. They can be helpful and even life-changing, but the antidepressant process can also be frustratingly slow. Knowing the potential side effects of antidepressants is essential to remaining informed about your condition, but so is understanding how these medications could help you. How will antidepressants make you feel? How long do antidepressants take to work? Why does it take so long for antidepressants to work?

Knowing how antidepressants work and how long they take can help you gauge your expectations if depression is reducing your motivation or causing you to doubt the effectiveness of your treatment. While the wait for symptom relief might feel lengthy, knowing the details of the antidepressant treatment process can help you assess its benefits and drawbacks, which may make the process smoother and more tolerable.

How Will Antidepressants Make Me Feel?

 Antidepressants are meant to help you get back to your non-depressed baseline. For some people, it can be hard to remember what this feels like or to imagine feeling anything other than depression, but many people do find relief from their symptoms through antidepressants. However, antidepressants are not "happy pills," as they are sometimes called, and they won't make a person immune to emotional discomfort.

Because the benefits can take time to appear, it isn't always immediately obvious what is changing. It is common for people with depression to notice improvements in retrospect or for loved ones to see a shift first. You might, for instance, be surprised to realize that you have gone three days without showing signs of emotional exhaustion, or you may find yourself genuinely laughing at a coworker's joke. It might feel natural to resume an activity that you once enjoyed, such as reading for pleasure. When antidepressants are working as intended, improvements often do feel natural.

How Long Do Antidepressants Take to Work?

Antidepressants don't result in immediate relief of symptoms. Some individuals experience initial improvement in 1-2 weeks, while others notice smaller, more gradual changes accumulating over the ensuing weeks of treatment. It typically takes 4-6 weeks or more to see the full effect of medication at any particular dose. Dose adjustment is often needed, and different doses are needed by different people. 

With that said, medications usually have a “starting dose” which is smaller and an average or “typical” dose, which is higher. Some people improve with a smaller dose, and some need higher doses. Some people see benefits with smaller doses, but if these don't produce the desired effect, it can take time to increase to an adequate amount of the medication. Because incrementally raising the dose requires additional time, the full benefits of antidepressants may take longer than 4-6 weeks to become apparent if the dose needs to be increased.

Several factors can contribute to how long antidepressants take to work, but the exact ways that antidepressants relieve depression are not yet fully understood.

The most commonly used antidepressants increase serotonin signaling in the brain. Serotonin is a messenger hormone (or neurotransmitter) that is thought to contribute to positive emotions by supporting communication between the brain and other parts of the nervous system. The increase in signaling happens relatively quickly when a person starts using antidepressants, but depressive symptoms typically aren't alleviated at the same pace. Other downstream changes occur as a result of the increased serotonin signaling, and these modifications take time to manifest and influence depression symptoms. Which process is the primary source of antidepressant response has yet to be determined, so treating depression with antidepressants isn't as simple as just increasing brain serotonin. 

Another factor that may contribute to the time needed for a clinical response is the medicine's therapeutic dose, described above. Because the starting dose of the medication often isn't the therapeutic dose, antidepressant medications are started at smaller amounts to allow the body time to adjust and avoid side effects. The pace of dosage adjustment may be influenced by how a person tolerates the medicine. If there are side effects, a slower adjustment (or titration) rate may be necessary, which would result in additional time before a therapeutic dose is reached.

At the beginning of treatment, you and your provider will decide whether to stay at the initial antidepressant strength long enough to assess for clinical response, or to titrate up to the average therapeutic dose steadily. Because it can take a long time for antidepressants to produce an effect, some individuals with depression opt to raise the medicine past the initial dose before waiting for a response. If a person will ultimately require a higher dose, the decision to increase sooner may cut down the time it takes to see benefits. This decision is a matter of personal preference and should come after discussing and weighing the pros and cons of both approaches with your provider.

Knowing What to Expect Can Reduce Frustration

Despite producing effects at slow rates, antidepressants remain a fundamental part of the treatment strategy for depression. Confusion about what to expect when you start taking an antidepressant can add frustration to an already difficult situation, but by taking time to learn more about how antidepressants work, you can properly evaluate their benefits and advocate for treatment changes if necessary. If you've tried several treatment strategies and are still experiencing depression, know that you are not alone and that there is hope for relief. Taking time to consider the questions posed above will help you feel more confident about your path forward, but don't hesitate to  schedule a no-cost consultation for TMS to have more of your questions answered.