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Depression: medication for depression

What is the purpose of your medication?

The medicine is prescribed to correct the chemical changes in your nervous system that have caused your depressive illness. It is known that an important chemical is present in smaller amounts than usual. It is rather like a person low in iron becoming anaemic and being given iron until the system is restored to normal. Most people have an excellent response to the medication.

What is the nature of the medication?

The pills are called antidepressants. They are not tranquillisers, pep pills, nerve pills or drugs of addiction. They are designed to lift you out of your depression-to lift your mood and energy and your ability to cope with life.

How soon will the medication work?

It usually takes 2 weeks before you notice an improvement. Sometimes it is sooner, sometimes longer, depending on the medicine and the individual person. Because it is difficult to predict your chemistry, the pills may have to be juggled for the first few weeks or even changed if they do not suit.

What is the dosage?

The dose will be clearly explained in the directions on the bottle. The lowest effective dose will be prescribed and the tablets will be gradually increased as required. It is common to start with a smaller dose and then build up the medication.

What time of day should it be taken?

The timing is not important to get the desired results, but it is usual to take most (if not all) of the tablets at night-time. This ensures that you will have a good sleep, because drowsiness is one of the side effects. If you feel too drowsy in the morning, you will have to spread them out during the day. It does not matter when they are taken with respect to meals (during, before or after).

How long will the treatment last?

It is usual to take the tablets for about 4 months, and then they will be reduced slowly. Even if you feel much better after 3 weeks or so, it is important to keep taking the tablets to allow your chemical balance to steadily consolidate. Knocking off the tablets too early may cause a relapse.

What side effects can I expect?

You may experience no bothersome side effects, but you could get some of the following:

• sleepiness or drowsiness: avoid driving or operating machinery if you feel drowsy
• dry mouth: this is common; you can chew sugarless gum, have sips of water, suck ice or have gargles
• increased appetite: weight gain is common; choose your food carefully (low fat, low sugar, high fibre)
• constipation or difficulty passing urine (in older men)
• difficulty reading fine print
• dizziness on standing or getting up quickly

If you do experience some of these effects, it is usually a good sign that the medication is working. You soon adapt to most of these side effects, which can settle after 2 weeks.

What about alcohol?

Alcohol can interact with the tablets, making you more sleepy or more drunk! A small amount will not hurt you, but do not drink and drive.

What about pregnancy?

It is not advisable to take these tablets if you are planning to become pregnant.

Important points

• Take the tablets as instructed.
• Side effects tend to improve.
• Improvement takes 2 weeks.
• Plan to take them for about 6 months.
• Do not drink and drive.
• Keep the tablets away from children.
• Contact your doctor about any concerns.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia