Keaki Bryant
Antidepressants can be a godsend for those suffering from mental health issues, but what happens when they stop working? It's actually quite common for antidepressants to lose their effectiveness over time, and there are several reasons why this might happen. One theory is that the receptors in the brain become less sensitive to the medication. Other factors include drug interactions, substance use, pregnancy, new stressors, and changes in lifestyle or environment. If you think your antidepressant has stopped working, it's important to continue taking it and consult a healthcare professional. They can help you develop a new plan, which may involve adjusting your dosage, switching medications, or adding complementary treatments such as therapy.
| Characteristics | Values |
|---|---|
| Commonality | It is common for antidepressants to stop working, with one study finding a depression relapse rate of 23% within two years. |
| Reasons | Drug or alcohol use, pregnancy, new stressors, other medications, unknown reasons. |
| Side Effects | Nausea, vomiting, cramps, diarrhea, loss of appetite, excessive sweating, flushing, trouble sleeping, dizziness, tremors, restless legs, uneven gait, difficulty coordinating speech and chewing movements, mood swings, agitation, anxiety, mania, depression, irritability, confusion, paranoia, suicidal thoughts, hypersensitivity to sound, ringing in ears, "brain-zaps", "brain shivers". |
| Withdrawal Symptoms | Anxiety, depression, dizziness, flu-like symptoms, abnormal sensations, physical complaints, mood swings, agitation, anxiety, mania, depression, irritability, confusion, paranoia, suicidal thoughts, hypersensitivity to sound, ringing in ears, "brain-zaps", "brain shivers". |
| Prevention | Storing medication properly, avoiding substance use, discussing new medications with a doctor, adjusting dosage, switching medication, psychotherapy, lifestyle changes, self-care. |
Drug tolerance
When this happens, your doctor may suggest changing your prescription, such as increasing the dose, adding another medication, or switching to a different class of antidepressant. They may also recommend starting psychotherapy or counselling as part of your treatment plan, and/or making lifestyle changes.
It's important to remember that losing response to antidepressants is not your fault. It's a common issue and can be due to factors beyond your control, such as medical conditions and ageing. If you think your antidepressant is losing its effectiveness, talk to your doctor about your options.
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Interactions with other medications
Antidepressants can be rendered ineffective or dangerous when taken in conjunction with other medications. This is because some medications are processed by the body along the same pathways as antidepressants, which can change how the antidepressant works. For example, some antibiotics can increase or decrease the amount of antidepressant in the bloodstream, affecting how well it works.
Even over-the-counter medications, vitamins, and supplements can interact with antidepressants. For instance, taking St John's Wort with an antidepressant can lead to serotonin syndrome, a serious condition.
Some foods and drinks can also interact with antidepressants. Grapefruit and grapefruit juice, for example, should not be consumed with BuSpar and Zoloft as they change the amount of medication in the body.
Drug interactions can also increase the risk of adverse side effects. For example, taking an MAOI with an SSRI can lead to serotonin syndrome. MAOIs also interact with certain foods and other drugs.
When prescribing antidepressants, doctors must take into account all the medications a patient is taking, including prescription, over-the-counter, vitamins, and supplements.
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Substance use
If you are using alcohol, nicotine, or any illicit substances, it is crucial to be honest with your healthcare provider. They need this information to prescribe medications and recommend treatments that are safe and effective for you.
If you are struggling with substance use while taking antidepressants, consider reducing or eliminating your substance use. This may involve seeking professional help to address the underlying causes and develop healthier coping strategies. Additionally, lifestyle changes, such as improving your diet, exercising regularly, and reducing stress, can also enhance the effectiveness of antidepressants.
It is important to remember that stopping substance use abruptly can lead to withdrawal symptoms and other health complications. Therefore, it is always advisable to seek professional guidance when making any changes to your substance use or medication regimen.
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Pregnancy
Antidepressants and anti-anxiety medications during pregnancy are a complicated issue. While some doctors advise against taking these medications during pregnancy, others argue that untreated mental illness poses risks to the developing fetus.
Pregnant women often worry about the potential side effects of antidepressants and anti-anxiety medications on their babies. It is common for doctors to recommend that pregnant women with mood disorders discontinue their medications. However, this can leave mothers-to-be conflicted, as they want to do what is best for their baby's health but also need to manage their mental health.
Some of the risks associated with untreated mental illness during pregnancy include:
- Increased likelihood of unhealthy or dangerous behaviours such as smoking and substance use.
- Negative impact on prenatal care, with depressed mothers less likely to attend appointments or take prenatal vitamins.
- Higher levels of cortisol in babies, which can increase the risk of developing depression, anxiety, and behavioural disorders later in life.
- Increased risk of preterm birth and low birth weight.
On the other hand, there are potential risks associated with taking antidepressants and anti-anxiety medications during pregnancy. Some studies have linked these medications to an increased risk of miscarriage, birth defects, autism, preterm birth, and gestational hypertension. However, the evidence is mixed, and other studies suggest that these medications do not cause birth defects.
So, what should pregnant women do? The answer is not straightforward and depends on individual circumstances. Pregnant women should talk to their doctors about the risks and benefits of taking or discontinuing medication. In some cases, medication may be necessary to manage severe mental health issues. Additionally, psychotherapy, nutritional interventions, and better sleep may be recommended as alternative or complementary treatments.
It is important to prioritize both maternal mental health and the well-being of the baby. Pregnant women should not suddenly discontinue their medication without consulting their doctor, as rapid withdrawal can also carry risks. Each case is unique, and a collaborative approach involving the patient, their support system, and a multidisciplinary medical team is ideal for making informed decisions.
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New stress
If you are going through a stressful time, it is important to reach out for support from loved ones and professionals. A professional can help you review your antidepressant routine and determine if you need an adjustment.
Additionally, it is crucial to be mindful of other factors that may influence your mental health and the effectiveness of your medication. For example, substance use, pregnancy, and interactions with other medications can all impact your mental health and the absorption and metabolism of antidepressants.
It is always recommended to consult with your healthcare provider if you feel your antidepressant is not working effectively. They can help determine the underlying causes and make any necessary adjustments to your treatment plan.
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Frequently asked questions
It is important to continue taking your medication and consult a healthcare professional. They can help develop a new plan, which may include changing your dose or medication or starting talk therapy. Stopping antidepressants abruptly can lead to withdrawal symptoms and intensify your condition.
There are several possible reasons why antidepressants may stop working, including drug tolerance, substance use, pregnancy, new stress, and interactions with other medications. However, in many cases, there may be no clear reason, and it could be due to constantly changing stressors and factors in the brain.
Some signs that your antidepressant may not be working effectively include persistent low mood, unpleasant side effects, serotonin syndrome, development of tolerance, worsening of symptoms, and mood or energy improvements that are too extreme.
Discontinuation of antidepressants can lead to various withdrawal symptoms, including digestive issues, difficulty with blood vessel control, sleep changes, balance issues, control of movement problems, unwanted feelings such as agitation or confusion, and strange sensations like pain, hypersensitivity to sound, or "brain-zaps."
