What do you do if your antidepressant “kind of” works?

Image: Open Window, Collioure by Henri Matisse
Open Window, Collioure by Henri Matisse

Does your antidepressant “kind of” work? If you feel better, but not good or normal, after starting a new antidepressant, you’re probably experiencing what’s known as a “partial response.” This can be very frustrating, and unfortunately many people assume that a partial response is the best they’re going to get, especially if their doctor hasn’t fully explained the possible outcomes of trying a new antidepressant. Also, a doctor that’s rushed or less than thorough may not query the patient in enough detail to realize that the response is only partial.

Fortunately, there are a few options to consider when you get a partial response to an antidepressant. All of these, except perhaps the exercise option, should be undertaken under your doctor’s care.

1. Increase dosage

In many cases, doctors will start a patient off on a low dose of an antidepressant, especially if there’s some concern about how well the patient will tolerate the medication. Most antidepressants have several possible dosage levels. Ask your doctor if it raising yours might give you a better response.

2. Augment your current antidepressant with another medication

Over the past decade or so, doctors have started augmenting antidepressant treatment with another medication. In some cases this medication is an antidepressant, and in other cases doctors will add an anti-seizure or anti-psychotic medication. The possibility of contraindication (a negative outcome when the two medications are combined) exists, so this must always be attempted under a doctor’s care.

3. Exercise

Several studies have suggested that exercise can alleviate depression. Exercise not only relieves stress, which is believed to contribute to depression, but also gives you some immediate relief due to the endorphins that exercise produces.

4. Folic Acid

Folic acid is a low-cost way to supplement your antidepressant treatment. First, folic acid appears to enhance the performance of antidepressants. Second, a lack of folic acid is believed to contribute to depression. And third, some antidepressants are believed to deplete folic acid. Please note that no studies have been done on this topic since 1988, so these hypotheses are based mostly on anecdotal evidence.

Talk to your doctor first. You want to ensure that the folic acid will not contraindicate with your antidepressant or other medication you’re taking. It’s unlikely, but better safe than sorry. In addition, your doctor needs to be apprised of anything you’re using to augment your medication treatment.

5. Try a new antidepressant

Although I’ve listed this option last, it’s not necessarily the last thing you should try. The accepted reason for switching an antidepressant is if it does not alleviate the depression at all, but if your response to the antidepressant was minimal, your doctor may feel that switching to another medication altogether is a better course.

It’s very important to remember that you have a right to complete remission from depression on your antidepressant. It’s not asking too much. This is what is supposed to happen. If your doctor makes you feel that you should be satisfied with not being suicidal anymore or with feeling somewhat better, find another doctor.

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  1. I realized today that my medication is only kind of working, thanks to my dad. Thanks for this, I’m glad I’m not the only one. I just wanna get better.

  2. I have been on Lexapro for 7 months, and it was working up until about a month ago if I’m remembering right. I feel like it doesn’t work anymore. I cant explain it, but I know I should get my dosage upped. I used to have this attutiude of “I don’t care” and that may sound bad but it was wonderful!! I didn’t feel anymore. Now at least once or twice a week I’m very depressed/moody and I cry or get really angry.

  3. What do I do? I’ve been on fluoxetine 20 mg (1 daily) for 5 weeks now and I don’t feel any better. In fact, I feel worse… I’ve never been lower than I am right now and I swear no one gives a damn. I have a problem with secret keeping and radical honesty so I have told friends but they just tell me to get over it then laugh about me behind my back, tell me im not ‘that bad’ and that I don’t need the tablets. Only 3 people have been truly supportive, but only one of them knows how bad its got. Should I tell someone? Can’t tell parents, they call it attention seeking, self pity, overexaggeration etc. Then say if I keep talking they’ll have me sectioned. I’m desperate.

  4. I’ve never been seriously helped with antidepressants. All have only kind of helped. I went drug free for 2 years & now am such a mess…so far down. Dr.tried 2 ssri’s, separately, both made me so sleepy barely able to function after only 1 low dose. It’s been 2 weeks. I’m gonna give dr. another try. So afraid to go through those experiences again.

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