When do antidepressants start working, and when is review needed?
Sleep, anxiety or energy may begin changing in the first weeks, while mood improvement often takes several weeks, commonly four to eight. Timing varies by medicine and condition. Worsening symptoms or troublesome effects need review rather than waiting out that period.
Details
Track more than mood
Notice sleep, concentration and ability to manage daily activities. Side effects may appear before benefit. Discuss them instead of independently increasing doses or abandoning treatment. Early follow-up assesses tolerability, safety and how the plan is being followed.
If nothing seems to change
The prescriber reviews treatment duration, dose, missed doses, the diagnosis and other medicines. A change, talking therapy or a different approach may be appropriate. One unsuccessful medicine does not mean treatment cannot help. Do not stop suddenly because improvement has not been immediate.
When review is urgent
Thoughts of self-harm, severe agitation or marked behavioural change need urgent contact, especially after starting treatment or changing a dose. With immediate danger, contact emergency services and ask a trusted person to remain with you. Do not wait for the next routine appointment.
Related reading: Do SSRI antidepressants cause addiction or withdrawal?.