Resources We Trust Mayo Clinic: Antidepressants: Selecting One That’s Right for YouCleveland Clinic: AntidepressantsAmerican Psychological Association: Depression Treatments for AdultsAnxiety and Depression Association of America: Treatment & ManagementAmerican Academy of Family Physicians: Pharmacologic Treatment of Depression
Antidepressants can improve symptoms of depression, but certain things can either help them work or make them less effective.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293d14d9a6-bf3a-4538-87d2-d52c75b4bca2 Side effects from your antidepressant can also arrive well before it takes the edge off major depressive disorder (MDD) symptoms, which may make you feel like giving up on the medication.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295a8c7a27-a87c-4f33-a29f-b4572079a348e60dc2a1-f33c-4a05-9b50-8e3e8e597629abc39fec-da3d-4cbd-bf1e-1eed3072be69 But by working closely with your healthcare provider and adjusting some lifestyle factors, you can help your antidepressant work better. Here are five things that can make a difference.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293d14d9a6-bf3a-4538-87d2-d52c75b4bca2 1. Take Them on Time As a first step, try to take your antidepressant at the same time each day. Your body processes different antidepressants faster or slower than others, so the importance of timing can vary from drug to drug, says Gerard Sanacora, PhD, MD , a psychiatrist and the director of the Yale Depression Research Program in New Haven, Connecticut. “However … I would say, just knowing human behavior, it’s really important to set a routine,” says Dr. Sanacora. “If you know that you’re taking your medication every morning with breakfast, it helps you to be consistent with it, and that consistency helps you get the benefit of the medication,” says Claire Brandon, MD , a psychiatrist in private practice in New York City. Some antidepressants can make you sleepy or alert, so your provider can also tell you the best time to take it depending on those side effects, says Dr. Brandon. 2. Double-Check Drug Interactions If you take other medications regularly, know that some drugs can interact with your antidepressants and affect how well they work.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a8940e2d-d9d8-4899-8ff4-518988aa2fea For example, if you take a selective serotonin reuptake inhibitor (SSRI) like sertraline (Zoloft) along with another medication that boosts serotonin in your system, you can develop a rare but serious condition called serotonin syndrome .e60dc2a1-f33c-4a05-9b50-8e3e8e597629eda57ea9-c636-4dc6-ae5a-389d114c340b Antidepressants can also interact with these medications and supplements:e60dc2a1-f33c-4a05-9b50-8e3e8e59762981670582-ca18-4650-b530-8a4a1d7e237d Lithium (Lithobid), a mood stabilizer Cough or cold medicine with dextromethorphan (aka DXM)e60dc2a1-f33c-4a05-9b50-8e3e8e597629bc652ac9-c012-4db5-8144-13cc93f160e5 Tramadol (Ultram), a pain medicatione60dc2a1-f33c-4a05-9b50-8e3e8e597629d6306d06-72fa-4d13-98dd-558aba300ff7 Cyclobenzaprine (Flexiril), a muscle relaxere60dc2a1-f33c-4a05-9b50-8e3e8e5976298ea7e752-2127-40e3-96b5-5920b8a72f1b St. John’s wort, ashwagandha, valerian root, ginkgo biloba, and ginseng, herbs typically sold as dietary supplementse60dc2a1-f33c-4a05-9b50-8e3e8e5976292ee50e32-fb24-4427-8efb-8f5daad66ef4e60dc2a1-f33c-4a05-9b50-8e3e8e5976295fb9d485-51d0-417f-a1f3-2611616816ade60dc2a1-f33c-4a05-9b50-8e3e8e5976294d5d9694-c46b-45fd-b30c-afa09db8deda Blood thinners like warfarin (Coumadin, Jantoven) and clopidogrel (Plavix)e60dc2a1-f33c-4a05-9b50-8e3e8e59762928b2e967-fd72-4d59-93d5-22de8a221fa3 Benzodiazepines like diazepam (Valium), clonazepam (Klonopin), and alprazolam (Xanax)e60dc2a1-f33c-4a05-9b50-8e3e8e597629e8ecdb30-93bd-4884-a900-3f9ed88beaa3 Sleep medications like temazepam (Restoril) and zolpidem (Ambien) Heart medication like metoprolol (Lopressor, Toprol-XL, Kapspargo) and propranolol e60dc2a1-f33c-4a05-9b50-8e3e8e597629a8940e2d-d9d8-4899-8ff4-518988aa2fea It’s always a good idea to ask your pharmacist and your provider before you start taking a new medication or supplement, says Sanacora. 3. Tell Your Provider About Side Effects Antidepressants can cause uncomfortable side effects like headache, dizziness, dry mouth, and low libido.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ac0b507d-c73a-40b9-bea6-a5f98767c543 Some also cause nausea, weight gain, and trouble sleeping , especially at first.e60dc2a1-f33c-4a05-9b50-8e3e8e597629abc39fec-da3d-4cbd-bf1e-1eed3072be69 Side effects from antidepressants are usually mild and fade within a few weeks, says Brandon. “I do encourage patients to stick through for a little bit if they can.” But Brandon also takes side effects very seriously and works with her patients to adjust medications and doses if needed. “My number one piece of advice is to work with a psychiatrist you like and trust and to communicate with them early about any side effect concerns,” says Brandon. “Don’t go it alone!” 4. Exercise to Boost Your Mood Exercise can boost your mood, even if you can only manage a short walk every day.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292037986f-04c6-41d3-bcf0-cd2a77d7b42c For mild to moderate depression, physical activity can even work as well as medications or treatments like cognitive behavioral therapy (CBT), says Brandon. “If we combine all three [when appropriate], that’s where we’re really seeing change.” Your antidepressant will work best alongside lifestyle changes like regular exercise, says Sanacora. Antidepressants don’t make you suddenly feel happy, he says. Instead, these drugs aim to work to allow you to experience pleasure and reward, says Sanacora. “[But] you still need to go out and do the things that provide you that.” You can try walking, jogging, yoga, strength training, tai chi, or qigong — whatever you enjoy the most.e60dc2a1-f33c-4a05-9b50-8e3e8e597629eccd4f43-6950-4fbc-a402-d8fff4dc31dd 5. Optimize Your Diet Some foods and drinks can change how antidepressants work in your body. Sanacora recommends asking your pharmacist if any foods interact with your medication. These could include: Foods with tyramine (an amino acid, or protein building block), like aged cheese, anything fermented, and cured, smoked, or processed meats, among others.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294c84f3b2-a6d6-48f5-b0b2-99cc1baeb030 Grapefruit , which can increase the side effects of sertraline (Zoloft)e60dc2a1-f33c-4a05-9b50-8e3e8e59762971ed35d1-d195-4496-9617-2e4d88593277 Alcohol and recreational drugs , which cause mood changes and can make antidepressants less effectivee60dc2a1-f33c-4a05-9b50-8e3e8e5976293d14d9a6-bf3a-4538-87d2-d52c75b4bca2 Focus on foods that can improve your mood. “If we look at the research, the Mediterranean diet has the strongest evidence for reducing depressive symptoms and preventing depression,” says Brandon. This diet might work by decreasing inflammation and boosting your gut microbiome, Brandon says. More research is needed to understand how diet affects depression, says Sanacora. “In general, a healthy diet, where you’re getting sufficient carbohydrates, protein, fat, vitamins — is probably the best we can say at this point,” says Sanacora. Getting these nutrients from whole foods, rather than from supplements, is best. Avoiding ultraprocessed foods may also help. What to Do if Your Antidepressant Isn’t Working If you feel like your antidepressant isn’t working, tell your provider. They can help you figure out if you need a new medication, a different dose, or if you can try adding other therapies and lifestyle changes to help it work better. If you need to switch drugs, they will tell you how to taper your antidepressants (take less and less each week) so you can safely transition to a new medication.e60dc2a1-f33c-4a05-9b50-8e3e8e59762918de82f6-9dd5-4261-8428-e34d65551007