Depression Treatment

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

Image: Jane Morris (The Blue Silk Dress) by Dante Gabriel Rossetti
Jane Morris (The Blue Silk Dress) by Dante Gabriel Rossetti

Does your antidepressant “kind of” work? If you feel better, but not good or normal, after starting a new antidepressant, or starting on antidepressants for the first time, you’re probably experiencing what’s known as a “partial response.”

This can be very frustrating, and unfortunately many people assume that this partial response is the best they’re going to get, especially if their doctor hasn’t fully explained the possible outcomes of trying antidepressants. Also, a doctor that’s rushed or less than thorough may not ask you enough questions, or the right questions, to realize that your response to the antidepressant 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 or the side effects. 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. In fact, there’s new evidence that suggests that a lack of exercise can actually cause 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

It’s believed that some people with a specific genetic mutation are unable to process folic acid into folate. A deficiency of folate can lead to multiple health problems, including depression.

Although the type of folic acid that you need to take if you have this genetic mutation is a specific form called L-Methylfolate, taking regular folic acid or increasing your intake by eating foods rich in folic acid might make a difference. Folic acid – just regular folic acid – is cheap, so it won’t cost you that much to try.

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.

12 Comments

  • JAMES D Bradley

    the best hope for me now after being on only one mao inhibitor that helped for four years Nardil and then quit on me is genesight testing the only way to go I feel because it can tell you what you are lacking as far as serotonin or any other neurotransmitter you are lacking. It can also tell a lot more like if you have and thing like blood flow to the brain. It tells it there is a inherited gene from any one in your family going back pretty far. it cuts out the guess work the doctor has to go thru with you.

  • Todd

    It is stated here that no studies have been done on folic acid and depression since 1988. That is not true. There are clinical studies that were done, as recently as 2016. BE CAREFUL and do some research before buying folic acid supplements with the hope that it will make your Prozac work better. It is not that simple. For one thing, there is a significant percentage of people with depression (and population) who have an MTHFR gene mutation that makes it difficult for them to metabolize folate. Piling up folic acid that your body cannot metabolize is not a good idea and has health risks. But don’t just go by me, look it up. It’s the fully metabolized folate called L-Methylfolate that supports the production of neurotransmitters in the brain that control mood – serotonin, norepinephrine, dopamine… There is a lot of confusion and misinformation out there and a lot of people making money selling folic acid supplements to unsuspecting people with depression and MTHFR gene mutations. Do yourself a favor and request that your doctor help you get a pharmacogenetic test done by a reputable company to determine not only whether or not you have MTHFR gene mutations but any other gene/medication contraindications. The money you spend on that test could save your life, if not thousands of dollars on medications that will never work because of your unique genetic profile.

    • Deborah

      Thank you so much for this comment. I started my son on L-Methylfolate instead of regular folic acid, and we have seen a real improvement in his mood. Unfortunately, it’s much more expensive, but it has been worth it.

    • Phaht Dohng

      I started 10mg Lexapro increased to 20mg and lost all desire and ability to have sex. So going back to 10mg to see if anything changes because it’s freaking me out. My wife is smoking hot in all sincerity and she might as well be living with Richard Simmons at this point, I realized it was a possible side affect but it’s almost as if I had seen Rosie O’Donnell or Whoopi goldberg nude by accident or something because it’s completely shut off my interest.

  • hPlay

    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.

  • Whisper

    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.

    • Kristen Straubmuller

      My therapist, starting on our next telecall, we are going to begin doing EMDR. I have been googling everything I can about EMDR and what we will be doing ECT. This maybe the wrong site to ask this question but I still can NOT find out what we will be doing and or telling me anything about EMDR for my chronic anxiety and my Complex PTSD. Is it possible, at all if someone may SIMPLY just tell me what we will be doing and what I am to expect during our next session when starting this EMDR in 2 weeks. Please? I just would love a heads up on what to expect. Text at 443-786-1270 or email @ kstrau01@gmail.com, would be such a wonderful help. If this is not a correct site to get any answered, please may you fwd me a site or somewhere to go-to so I may read up on it. Thank you and Happy Holidays, Kristen Straubmuller Bowen. Thank you

  • anxious

    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.

    • Kristen S. Bowen

      I feel for you 100%. I also use to constantly get the same responses you exsplained from my friends and my family as well. The worst thing anyone can say to us is to ,” Just get over it”, damn that hurts and is so painful to hear, almost making me feel like more of a boring burden, when all I’m doing by talking and trusting them if I tell them, very vulnerably, is to just talk about what’s going on with me and for them to just listen and feel atleast some sympathy or empathy. So for more yrs then I can remember I would feel lonelier then ever, even in a group of my so called best friends. You’re not alone, you are more then welcome to text or email me anytime. You can FB msg me at kstrau01@gmail.com or email me there. My name in FB is under Kristen Straubmuller Bowen, the picture is of me holding my daughter when she was only a little under 2yrs old. That’s the correct FB account. Even if you just wanted to say hello, just let me know how you got my info so I’ll know what site we both are on. We are stronger then everyone thinks we are, just remember that. And you are not alone, I’m right there/here with you… imperfect, beautifully flawed and stronger then most. I hope to hear from you sometime. You may have written what I just read yrs ago, I’m writing this to you on 12/2021, the age of the horrible pandemic. -KSB-

  • Dawn

    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.

Leave a Reply to hPlay Cancel reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.