Before making the decision to try an antidepressant, consider the potential risks and benefits of this option.

On the plus side, antidepressant medications can and do save lives. They potentially alleviate mild, moderate, and severe depression symptoms in a short amount of time. They work well with other treatments such as psychotherapy and exercise, and there is significant research to support their value. They offer an ease of access and use that other treatment options do not.

However, antidepressant therapy is complex and carries significant risks. Everyone responds to medication differently, and there is an especially wide variation of responses to antidepressants. These medications may be inexpertly prescribed, and troublesome side effects frequently accompany potential gains. It is important to be aware of the pros and cons of this approach so that you can make an informed choice and develop a treatment plan that suits your needs.

Know the Basics

Antidepressants impact neurotransmitters and brain chemicals that influence mood. Antidepressants are unlike antibiotics and other medicines that you may have taken; they work differently in your body and may not prompt an obvious, rapid recovery.

Bear in mind that most antidepressant medications take two to four weeks to reach full effectiveness. That means that you may not experience relief for the first few weeks. And for many, even the most effective antidepressants provide only partial symptom relief. It can help to use a depression scale to monitor how your symptoms change over time (Click the link following this article for the Burns Depression Checklist).

There are dozens of popular antidepressants, and each carries certain advantages and risks. Because there is no way to predict whether your depression symptoms will respond to a specific antidepressant, there is some degree of guesswork involved in making a match. You may need to try two, three, or four different medications before you find one that works for you.

Your doctor may even prescribe a combination of medications to boost effectiveness or to minimize side effects. And because it can take weeks before you know if your medication is working, it may take several months to fine-tune your prescription.

Once you start, it’s essential that you don’t stop cold turkey or jump from one medication to the next. Because these medications affect brain chemicals, you must follow a gradual reduction in dosage in order to avoid serious withdrawal symptoms (which may include intensified depression). Even if you don’t think the medication is working, it is critical that you follow your doctor’s instructions to “wean” yourself off of your medication little by little.

Side Effects

Side effects are common with antidepressants. Most people experience mild symptoms such as headaches or nausea that diminish or disappear within a few weeks of initial treatment. Yet these medications carry the risk of more serious side effects like diarrhea, rash, weight loss/gain, anxiety, tremors, sexual dysfunction, and seizures.

Educate yourself about your medication’s potential side effects and report any discomfort to your prescriber immediately. If your side effects are tolerable, you and your doctor may decide to wait for the symptoms to dissipate on their own. If not, you will need to plan for gradual medication change.

Get Expert Care

Antidepressant treatment requires subtlety and discretion in medication choice, dosage, and after-care. General practitioners, internal medicine physicians, physician’s assistants, and nurse practitioners frequently introduce patients to antidepressants and can be a convenient source for antidepressant information and prescriptions. However, I advise you to evaluate your provider’s expertise in this area.

Most providers don’t possess the knowledge and training to explore your mental health needs, options, and risks as thoroughly as a psychiatrist or psychiatric nurse will do. Psychiatrists specialize in mental health diagnosis and treatment. If your insurance plan allows you to consult with a psychiatrist, this may be the safest route to initiate and monitor your antidepressant treatment regimen.

Evaluate Your Needs

Make sure your decision is consistent with your physical, mental, and emotional goals and comfort zones.

Timing and Readiness
• Do your depression symptoms interfere with your ability to function?
• Have your friends, family members, or doctor urged you to try antidepressants?
• Is the time right to start a new medication?
• How will you know if it’s working? How long will you wait before trying something else?
• How long do you expect or plan to take antidepressant medication? A year? Five years?

Medical Issues
• Do you understand antidepressants’ potential benefits, side effects, and outcomes?
• Do you have other conditions or medications that would be affected by antidepressants?
• Which side effects would you be willing to tolerate?
• Which side effects would cause you to stop or change your medication?
• Have you talked to your doctor and/or therapist about your questions and concerns?

Other Considerations
• Have you explored non-medical treatments like cognitive-behavioral therapy, exercise, and acupuncture?
• Will you supplement medication with a non-medical approach?
• What treatments have worked for you or family members in the past?
• How will you address underlying emotional and lifestyle aspects of your depression?
• Will others in your life support your choices and success?

Think about these issues and weigh your options carefully. Only you and your health care providers can decide if antidepressant medication is right for you. And then you must carefully monitor your progress and communicate with your health care providers.

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Research shows that, like antidepressant medications, cognitive therapy is a highly successful depression treatment. If you decide to use cognitive therapy to treat your depression, I recommend the self-help classic Feeling Good by David Burns. Feeling Good outlines the basics of the approach and walks you through the process of changing negative thought patterns. Click here to read excerpts and buy Feeling Good at Amazon.com