Answers to your top questions about antidepressants

According to Dr. Soti, the type of depression treatment a doctor recommends depends on the severity and duration of symptoms and patient preference. “I always ask the patient whether they’ve had any changes with their sleep and appetite and whether they’ve had thoughts of harming themselves,” she says.

Dr. Soti adds that, generally, lifestyle changes such as exercising, eating healthily and practicing good sleep hygiene can be effective to treat mild depression, while combining therapy with medication can be effective for moderate depression.

Dr. Kane says that severe depression often requires initial treatment with inpatient or intensive outpatient programs, which can include therapy, medication, lifestyle changes and social support.

“Antidepressants aren’t necessarily the go-to route to treat depression,” says Dr. Soti. “Ultimately, deciding to take an antidepressant is made after a patient has a thorough discussion with their doctor.”

For example, Dr. Soti first recommends therapy for someone who is experiencing a social issue, such as a relationship conflict or financial challenge. Dr. Kane adds that a proper diagnosis should be made by examining whether a patient’s symptoms meet clinical criteria before prescribing an antidepressant.

“A doctor isn’t a medication salesperson,” he says. “It’s important they help the patient understand the whole picture of treatment with an antidepressant, and the decision is made in a collaborative manner.”

When it comes to antidepressants’ rumored side effects, such as dependency, personality changes, weight gain or emotional “numbing,” Dr. Soti says they can be discussed with a doctor. “There are various antidepressants that have a low risk for each concern,” she says.

What’s more, the probability of side effects depends on the dose of an antidepressant, since the risk usually rises as the dose increases. A doctor can help manage the dose, monitor side effects and schedule frequent check-ins.

“The goal is to help patients understand the benefits of treatment as well as any potential risks so they can make an informed decision for their own care,” says Dr. Kane. “If a person experiences uncomfortable side effects without noticeable benefits from a medication, I will always recommend changing the treatment until we find something that works.”

“I try to understand why a patient wants to stop taking an antidepressant because, oftentimes, the medication can take several weeks to become effective,” says Dr. Soti. “We want to give the medication a fair chance to work.”

Dr. Soti also says that doctors can help patients try a different dose or switch to a different antidepressant altogether.

Whatever the decision, both Dr. Soti and Dr. Kane emphasize the importance of safety, as some antidepressants can cause dangerous symptoms if a patient suddenly stops taking them. Doctors can help patients safely stop taking an antidepressant by gradually decreasing the dose.

According to Dr. Kane, antidepressants don’t need to be taken forever. “We evaluate whether the medicine has been effective over time,” he says. “We can also help with ways to decrease the likelihood of a relapse.”