Why Are My Antidepressants Not Working? Six Reasons Antidepressants Fail

Antidepressants are prescribed to manage depression and other mental health conditions. However, there are times when these medications may not work as expected. Here are some reasons why your antidepressant medication may not be working:

1. Incorrect Diagnosis

If your diagnosis is incorrect, the medication prescribed may not be the right one to treat the symptoms you’re experiencing. For example, antidepressants are often quite helpful for depression. However, if you suffer with bipolar depression, antidepressants may not be the best choice. Other medications may be more effective. If you were given the wrong diagnosis for your type of depression, an antidepressant medication might not work as well for your condition. Making sure to fully report the symptoms you are experiencing now, as well as those you have experienced in the past, can assist your psychiatric provider to diagnose you correctly.

2. Too Small of a Dosage

Sometimes, the dosage of the antidepressant may not be high enough to have an effect. Imagine only taking 1/2 tablet of ibuprofen for a headache; it is unlikely this dose will help your headache to get better. The same general idea usually applies to antidepressants. Your antidepressant may work if dosed correctly, but working with your psychiatric provider to adjust the dose may be required. Psychiatric providers often will start low on the dose of a medication to ensure it is tolerated. However, the dose may need to continue to be increased over time to achieve the desired effect. Be sure to let your psychiatric provider know how you are responding to your medications.

3. Inadequate Time on the Medication

Similarly to being on too small of a dosage of an antidepressant, you may not have been on the antidepressant long enough. While a response can often be noticed in a week or two on many antidepressants, it often can takes several weeks to reach full effect. It is important to allow the medication enough time to work before giving up on it.

4. Drug Interactions

Some medications or substances interact with antidepressants, reducing their effectiveness. For example, medications such as Tegretol (carbamazepine), which is frequently used for seizures and mood stabilization, can reduce blood levels of certain antidepressants like Wellbutrin (buproprion), Lexapro (escitalopram), and Celexa (citalopram), resulting in these antidepressants being less effective. In addition, smoking cigarettes or marijuana can result in reduced blood levels of antidepressants such as Cymbalta (duloxetine), Tofranil (imipramine), and Anafranil (clomipramine). Make sure your psychiatric provider is aware of all the medications and substances you consume.

5. Non-Adherence to Medication

Not taking an antidepressant is a common reason why antidepressants end up not working. Sometimes forgetfulness is at the root of not taking your antidepressant. If this is the case, having medication alarms or the assistance of a family member providing reminders can be extremely helpful. Other times, people have mixed feelings about taking their antidepressants for various reasons. These reasons can include side effects, uncertainty about needing the medications, negative thoughts associated with the medications, and others. These feelings are often very understandable. However, it is important to address these feelings with your psychiatric provider and develop a medication plan that will result in you feeling comfortable taking the medication. Your antidepressants will not work if you do not take them and are not likely to work as well if you take them inconsistently.

6. Metabolic Differences

Everyone’s body is different, and these differences can affect how your body metabolizes antidepressants. Factors such as age, weight, sex, and overall health can influence how your body responds to medications. As a result, you may require different doses of an antidepressant than someone else who is taking the same medication to reach the desired effect. In addition, certain antidepressants may simply not work for you. Continue to work with your psychiatric provider to find the right medications and doses to address your symptoms.

Remember, it’s crucial to communicate with your psychiatric provider if you feel your antidepressant isn’t working. Knowing this information, your psychiatric provider can work with you to adjust your medication treatment plan and find solutions. Wishing you continued success on your mental health journey!

David Newby, APRN, PMHNP-BC

Breezy Mental Health, LLC

Disclaimer: This article is for informational purposes only and should not be used as a replacement for medical advice. Always consult with a healthcare professional for accurate information for your situation.