Treatment for depression

When you start treatment for depression, your doctor will tell you when you might start to feel better. Be sure to follow your doctor's instructions about:

• What you should do to treat depression.
• How to take your medicine if you are using a medicine.
• When to call if you are not feeling better.

You may start to feel better within 1 to 3 weeks of taking antidepressant medicine. But it can take as many as 6 to 8 weeks to see more improvement. If you have questions or concerns about your medicines, or if you do not notice any improvement by 3 weeks, talk to your doctor.

When you first start an antidepressant, you may experience side effects of the medicine. Many of the side effects are temporary and go away with continued use of the medicine, although some (such as dry mouth, constipation, and sexual effects) may continue.

Taking your medicine for at least 6 months after you feel better can help keep you from getting depressed again. If this is not the first time you have been depressed, your doctor may want you to take these medicines even longer.

• Do not stop taking the medicine on your own unless you are having chest pain, hives, shortness of breath, trouble swallowing, or swelling of your lips. Contact your doctor immediately if you experience any of these serious side effects.
• If your side effects are less serious, talk with your doctor to see whether you should continue the medicine or try another one. There are many things you can do to reduce side effects of medicines.

Antidepressant medicines may need to be started at low doses and increased gradually, especially in most older adults. Medicines should also be stopped gradually by decreasing the dose over a period of time. If certain antidepressant medicines are stopped abruptly, you may suffer negative effects or the symptoms of depression may return.

Older adults or others who are depressed and taking several medicines for other health conditions (not related to depression) need careful monitoring of their medicines. People are more likely to develop harmful side effects from taking many different medicines.

FDA Advisories. The U.S. Food and Drug Administration (FDA) has issued:

• An advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines, but to watch for warning signs of suicide in those using them. This is especially important at the beginning of treatment or when doses are changed.
• A warning about the antidepressants Paxil and Paxil CR and birth defects. Taking these medicines in the first 12 weeks of pregnancy may increase your chance of having a baby with a birth defect.