Clues Your Antidepressant Is Working: Wellbutrin, Lexapro, Effexor, and More

Antidepressants like Wellbutrin (bupropion), Lexapro (escitalopram), and Prozac (fluoxetine) can be a great choice for treating major depression, anxiety disorders, and other mental health conditions.

But sometimes it can be hard to tell if your antidepressant is working - especially since it can take weeks or even months before you see an effect. And in some cases an antidepressant only helps a little (but not as much as you'd like), or it stops working after you've been taking it for a while.

With all this in mind, you may be wondering if your antidepressant is helping. So, what are the signs that your medication is working? And if you don't think it's helping, what can you do? Read on for answers to these questions and more.

How do you know if your antidepressant is working?

Antidepressants take a while to start working - usually a month or more. And changes don't usually happen all at once. They're gradual. This means it may take time before you know whether your antidepressant is a good match.

But if you're taking an antidepressant, here are three clues that you're on the right track:

• Your thoughts or feelings have changed for the better. You may find yourself feeling less depressed or anxious, or have a more positive outlook on life. Or maybe you're able to enjoy life more fully again, or feel more engaged at work, school, or home. You may also have noticed fewer negative thoughts.

• You're less preoccupied by your mental health symptoms. Even if you still have symptoms, they take up less time and energy in your life. It's easier for you to do your normal daily activities, without having to spend a lot of energy managing your symptoms.

• You feel better physically. You might notice that you're sleeping better, or have more energy during the day. Maybe your appetite has returned. Or maybe you have physical symptoms that have gotten better, like headaches or stomach aches.

In reality, only you can know for sure whether your antidepressant is working. It depends on your unique symptoms and experiences. The bottom line? If you're feeling better, and feel good about continuing to take the medication, it's probably working for you.

How long do antidepressants take to work?

It's hard to say. Some people start to feel better in 1 to 2 weeks. But the truth is, antidepressants work slowly. It can take up to 2 months before they reach their full effect.

If you do notice an improvement in your symptoms in those first couple of weeks, this can be a sign that your antidepressant is a good fit for you. On the other hand, if you haven't noticed any benefits in the first month, don't give up. You may just need more time for the medication to start working.

And keep in mind: It's normal to have side effects when starting an antidepressant. These side effects can actually make you feel like you're getting worse, instead of better. But hang in there. For most people, antidepressant side effects get better within the first couple weeks. If they don't, it's possible that your dose could be too high.

How do you know if your antidepressant is not working?

If you've been taking an antidepressant for at least 1 month and haven't seen any benefits, it's possible that it isn't working. Here are some things you might notice:

• You feel the same amount of sadness, anxiety, or irritability.

• You feel slightly better, but your symptoms still make it hard to function in daily life.

• You're having trouble sleeping, or sleeping too much.

• You don't feel interested in your usual activities.

• You feel guilty or worried about how your symptoms affect other people.

• You're having trouble concentrating or thinking clearly.

• Your body feels weighed down or restless.

• You have low energy, or you feel tired.

If you're experiencing any of these, talk to a healthcare professional. It's possible that your antidepressant isn't the right fit for you. Or maybe you just need to give it more time to work, or you need to change to a different dose.

It can be frustrating to feel like your medication isn't working. But don't give up. Fortunately, no matter what the situation, there are still many things you can try (more on this below).

Signs your antidepressant dose may be too low

If you've been taking your antidepressant for at least a month and it doesn't seem to be working, it's possible that your dose is too low. Most antidepressants have a range of different doses. Some people need a higher dose to treat their symptoms.

Signs your antidepressant dose may be too high

If you're still having a lot of side effects after the first couple of weeks, it's possible that your medication dose is too high. These might include:

• Feeling emotionally "numb"

• Experiencing significant weight loss or weight gain

• Having "brain fog" or trouble concentrating

• Feeling sleepy or drowsy during the day

• Sleeping too much or too little

• Sweating

• Feeling "jittery" or restless

• Having diarrhea or constipation

• Experiencing sexual side effects, like low libido or inability to have an orgasm

If you have concerns, talk to a healthcare professional. They can help you understand the pros and cons of lowering your antidepressant dose - especially if it's been working well for your depression or anxiety.

Quiz: Am I depressed?

How do antidepressants work in your body?

Antidepressants work by changing levels of certain chemicals in the brain called neurotransmitters. Scientists believe these changes help improve mood and reduce depression and anxiety.

The main types of antidepressants are:

• SSRIs (selective serotonin reuptake inhibitors): Examples include sertraline (Zoloft), fluoxetine (Prozac), and escitalopram (Lexapro). These mostly work by increasing levels of the neurotransmitter serotonin. They do this by stopping the reabsorption of serotonin back into nerve cells. This allows more serotonin to be available in the brain.

• SNRIs (serotonin and norepinephrine reuptake inhibitors): These include venlafaxine (Effexor) and duloxetine (Cymbalta). They're similar to SSRIs. They mostly stop the reabsorption of serotonin and norepinephrine into nerve cells, which increases the amount of these chemicals in the brain.

• MAOIs (monoamine oxidase inhibitors): Examples include tranylcypromine (Parnate) and phenelzine (Nardil). They increase levels of dopamine, serotonin, and norepinephrine in the brain. MAOIs stop the effects of the monoamine oxidase enzyme, which breaks down these chemicals.

• Tricyclics: These include amitriptyline (Elavil), imipramine (Tofranil), and clomipramine (Anafranil). They're similar to SNRIs in that they mostly seem to work by blocking the reabsorption of serotonin and norepinephrine into nerve cells.

• Wellbutrin (bupropion): This is an atypical antidepressant. Other atypical antidepressants include trazodone (Desyrel) and mirtazapine (Remeron). They work by altering levels of serotonin, dopamine, and norepinephrine in the brain in different ways than other types of antidepressants.

What can you do if your antidepressant is not working?

First, be patient. Remember: It can take weeks, or even months, for antidepressants to work.

But if you've been taking your antidepressant for a month or longer and haven't noticed any benefits, here are some ideas to consider:

• Speak to a healthcare professional about adjusting your medication. In some cases, changing the dose, frequency, or schedule of your current antidepressant can help. Remember: You should never change the dose of your antidepressant without talking to your healthcare team.

• Switch to or add another antidepressant. There are many different types of antidepressants on the market, and people may respond differently to them. Sometimes you and your healthcare team will have to try different medications to find the one that's best for you. You can speak with them about whether it would be helpful to change your current antidepressant or add another one.

• Combine medication with therapy. There's evidence that medication and therapy together may be more effective than medication alone. If you're interested in finding a therapist, you can ask your primary care provider for referrals, contact your health insurance company, or do an online search for local mental health professionals.

• Attend a treatment program. If you're facing challenges with drugs or alcohol, attending a treatment program for substance use disorder may help. Your drug and alcohol use may be interfering with your antidepressant. Once you stop using drugs and alcohol, you may find that your antidepressant works differently.

• Attend a support group. It can be lonely dealing with depression and anxiety. Connecting with other people can go a long way. Consider joining a support group, like the ones offered by the National Alliance on Mental Illness (NAMI).

Frequently asked questions