Medication for Depression

Part of our Depression articles. For evaluation and medication management, see depression care at Ridge Way.

For many people with depression, medication can be an important part of treatment. Therapy helps with the emotional and behavioral side of depression. Medication works on the biological side. Starting medication can still feel overwhelming, with worries about side effects, dependence or stigma.

This post explains how antidepressant medications work, what to expect, and how they fit into a broader treatment plan.

[Image: An older man doing a newspaper crossword at a kitchen table. Medication for depression.]

Why Medication Is Used for Depression

Depression is not a personal weakness, and it cannot be reduced to a simple chemical imbalance. Research suggests that genes, biology, life circumstances and psychology all play a role.

Antidepressants work by changing how the brain produces or uses certain chemicals involved in mood or stress. They can ease symptoms and make it easier to take part in therapy and daily life. Medication alone is not a cure. Treatment usually means psychotherapy, medication or both.

Types of Antidepressants

Several classes of antidepressants are used to treat depression. The choice of medication depends on your symptoms, your health history and how you respond. Read more about how antidepressant medication is used.

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are commonly prescribed. NIMH notes they help many kinds of depression and anxiety. They also have fewer side effects than older antidepressants. Sertraline (Zoloft) is one example.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs are another commonly prescribed class. Venlafaxine (Effexor) is one example.

Tricyclic Antidepressants (TCAs)

Tricyclics are an older class of antidepressants. They are associated with more side effects, but they may be the best option for some people. Nortriptyline (Pamelor) is one example.

Monoamine Oxidase Inhibitors (MAOIs)

MAOIs are also an older class with more side effects. They may be the best option for some people. People taking an MAOI such as phenelzine (Nardil) must avoid foods high in tyramine, such as aged cheese and smoked meats.

Other Antidepressants

Some antidepressants do not fit the classes above. Bupropion (Wellbutrin) acts on two brain chemicals, norepinephrine and dopamine. Mirtazapine (Remeron) is another option, and drowsiness is one of its side effects.

What to Expect When Starting Antidepressants

Antidepressants take time to work, usually 4 to 8 weeks. Problems with sleep, appetite, energy and concentration often improve before mood lifts.

Side effects are common when beginning treatment. Common side effects of SSRIs and other antidepressants include upset stomach, headache and sexual problems. They are generally mild and tend to go away with time. If side effects persist or become severe, your prescriber can adjust the dose or switch medications.

Finding the right medication can take time. People respond to medications in different ways. It may take a few tries to find the one that works best with the fewest side effects. Regular follow-up visits let your prescriber make adjustments as needed.

In some cases, children, teens and young adults under 25 may have more suicidal thoughts or behavior when they start an antidepressant. This is most likely in the first few weeks. Antidepressant labels carry a boxed warning about this. Watch for changes and tell your prescriber right away. If you have thoughts of suicide, call or text 988, or call 911 if you are in immediate danger.

Benefits of Antidepressants

The main benefit of antidepressants is symptom relief. Easing sadness and fatigue can make it easier to return to daily life and relationships. Many people find that better mood and energy make it easier to take part in therapy and the things they value.

Antidepressants can also help physical symptoms of depression, such as sleep and appetite problems. In some cases, providers prescribe antidepressants for other conditions, such as anxiety, pain and insomnia. Read more about the physical symptoms of depression.

Addressing Common Concerns About Antidepressants

A common worry is dependence. Stopping an antidepressant suddenly can cause discontinuation symptoms. For sertraline, these can include nausea, dizziness, irritability, headache and trouble sleeping.

Stopping too fast may also make depression come back. Do not stop taking a prescribed antidepressant, even if you feel better, without your provider’s help. Your provider can lower the dose gradually and safely.

Some people worry about taking antidepressants long term. How long you take medication depends on your needs and should be discussed with your prescriber.

Stigma can also be a barrier. Antidepressants are a medical treatment, like medicine for any other health problem. Asking for help is a sign of strength, not weakness.

The Role of Therapy in a Treatment Plan

Antidepressants work on the biological side of depression, while therapy works on thoughts and behaviors. In cognitive behavioral therapy (CBT), people learn to challenge and change unhelpful thoughts and behaviors. Interpersonal therapy (IPT) focuses on relationships and life events that affect mood. Medication is often used with talk therapy.

Ridge Way does not provide therapy. When therapy would help, our medical team can refer you to a therapist.

When to Get Help

Consider an evaluation when depression gets in the way of work, relationships or enjoying life. The same is true when changes in mood, interest, sleep, appetite, energy or focus last two weeks or longer. You can take our depression screening as a starting point.

Ridge Way provides psychiatric evaluation and medication management for adults, teens and children age six and older, in Sugar Hill and by telehealth across Georgia. We do not provide therapy. When therapy would help, our medical team can refer you to a therapist.

You do not need a referral unless your insurance plan requires one. Request an appointment and we will usually call you back within one business day.