Why might my antidepressant not work?

Dr. Pina LoGiudice, LAc, ND
Naturopathic Medicine
As one of the most well prescribed types of drug of all time, over 160 million antidepressant prescriptions are written annually, despite the fact that a 2010 study in the Journal of the American Medical Association revealed antidepressants to be no more effective than placebos (sugar pills) in most cases of depression.

The reason why antidepressants do not work in most cases of depression is because these drugs target only one aspect of this complex condition: neurotransmitters, the brain's "mood molecules." When "feel-good" neurotransmitters like dopamine, epinephrine and serotonin are low, artificially raising the levels with the drugs can sometimes help in the minority of the most severe cases.
All depressions are not the same. This may explain why some antidepressants work better in some people than others. Unfortunately, we do not have the ability to determine with certainty which type of depression you have and which medication will work best. Experienced healthcare professionals can make an educated guess at which antidepressant may help the most, but it is not uncommon to have to try several different antidepressants until you find the one that works well with fewest side effects.

Another reason your medicine may not work is that your body may not be metabolizing the medicine as it should. There are now genetic tests available that can help determine how you metabolize these medicines. You must also make sure you are taking the medicine regularly and are on the right dose. Often, antidepressants are under-dosed when prescribed by less experienced doctors. Lastly, unhealthy lifestyle choices can impact the medicines’ ability to help, including high stress levels, poor diet, drug or alcohol use and lack of physical activity and sleep.  Remember, antidepressants are only one part of the treatment strategy to treat depression. 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.