If one antidepressant doesn't work, your doctor can probably find one that will.(ISTOCKPHOTO) If you and your doctor are not satisfied with the amount of improvement you've had while on an antidepressant, you're not alone. In a three-month study of 4,000 depression patients, at least half didn't get complete relief from the first antidepressant they tried. Doctors talk about a "response" to an antidepressant, which means at least some improvement, and "remission," which means that the symptoms go away altogether. If one antidepressant doesn't do the trick, your doctor may consider the following options. When to switch antidepressants"My hope for every patient is that major depression remits as soon as possible with few side effects," says George I. Papakostas, MD, an assistant professor of psychiatry at Harvard Medical School. The three factors listed below go into his decision to call it quits with a particular drug or to continue using it and add something else. If you've had only a slight improvement in symptoms but the side effects are burdensome, your doctor will switch you to something else altogether. Sertraline belongs to a class of medications known as selective serotonin reuptake inhibitors (SSRIs). It is used to treat depression, panic disorder, and obsessive-compulsive disorder (OCD). Sertraline works by affecting the balance of chemicals in the brain. Specifically, it increases the level of a neurotransmitter called serotonin in the brain. Increased serotonin levels can help improve mood, reduce panic attacks, and treat OCD. Although improvements may occur earlier, the full response to the medication may not appear until after 4 weeks of treatment or longer. This medication may be available under multiple brand names and/or in several different forms.
When depression symptoms improve after starting an antidepressant, many people need to continue taking medication long term to prevent symptoms from returning. However, in some people, a particular antidepressant may simply stop working over time. Doctors don't fully understand what causes the so-called "poop-out" effect or antidepressant tolerance — known as tachyphylaxis — or why it occurs in some people and not in others. In most cases, depression symptoms get better with adjustments to medication. Your doctor may recommend that you change the dose of your current antidepressant, change to another antidepressant or add another antidepressant or other type of medication to your current treatment. Psychological counseling (psychotherapy) also may help. Because there are so many reasons depression treatment can stop working, you may need to see a medical doctor who specializes in diagnosing and treating mental illness (psychiatrist) to figure out the best course of action. Finding the right antidepressant often takes a special combination of perseverance and patience, which is why it's so frustrating to finally land on a treatment plan only to have it stop working years later. But it turns out that building up a tolerance to these types of medications is possible and probably more common than you think. It even happened to Sarah Silverman, she shared on Instagram this week. Silverman has been open in the past about her experience with depression and once said that she has been on antidepressants since she was 13. But, on Monday, she told fans that she hit a rough patch with her treatment.“I’ve officially built a tolerance to Zoloft and for some reason the subsequent free fall looks fucking great on me. #Silver Linings,” she captioned an Instagram photo featuring a close-up of her face. “I've gone through the Zoloft and other med tolerance and subsequent lack of efficacy,” one person wrote. “It really sucks hitting that point with a medication that actually worked for a bit.”Another commenter said: “I am in the exact same position right now after a while of being as healthy as I’ve been in a decade I feel the darkness encroaching.
Feb 29, 2016. Degree of improvement Have the depression symptoms improved in. Depending on a patient's exact diagnosis and tolerance for side effects. For the Consumer. Applies to sertraline oral solution, oral tablet. Along with its needed effects, sertraline the active ingredient contained in Zoloft may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.