Medication for depression won’t erase symptoms overnight, but it can make a big difference in how you feel day to day. Before prescribing anything, a psychiatric provider will typically ask about your medical history, any past experiences you’ve had with medication, and family mental health history.
Finding the right medication and dose can sometimes take a few tries. Your psychiatric provider will work alongside you to monitor symptoms and side effects, adjusting as needed until you land on what actually works for you.
What It’s Like to Seek Depression Medication
If you’re considering medication or one of your providers suggests it as a potential option, you might not know where to start or what to expect. While your general practice doctor could prescribe medication, we recommend working with a designated psychiatric provider. These providers have years of experience treating mental health specifically, with deep knowledge of these medications and potential side effects to watch for.
At your first appointment, a psychiatric provider will ask you several questions about your family’s mental health history, your current symptoms, any previous experiences with mental health concerns or medications, and your lifestyle. Based on all this information, your provider could prescribe a medication, explaining how it works, any side effects to watch for, and the general timeline for you to start expecting changes. They’ll also leave plenty of time for you to ask questions, and you’ll schedule regular follow-up appointments to track progress over time.
What Are Antidepressants?
Antidepressants function by helping the brain produce and process neurotransmitters more effectively, which work to change mood and energy. Most antidepressants target serotonin, norepinephrine, or dopamine, since many people with depression show lower levels of these chemicals.
Some people might think of these medications as changing your personality or even causing “zombie-like” reactions. Antidepressants can be incredibly effective for increasing your brain’s access to important chemicals, but they do nothing to change the core of who you are. Our clinicians care about the whole of your mental health, and schedule regular check-ins, as well as working closely with your therapist for comprehensive support. If you start a medication and have an adverse reaction or don’t like the way it makes you feel, share this openly with your prescriber and your therapist.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are often the starting point for depression medication, thanks to their strong track record and relatively few side effects and risks. They work by preventing the brain from reabsorbing serotonin too quickly, leaving more available to be processed.¹
Commonly prescribed SSRIs include:
- Lexapro (escitalopram)
- Zoloft (sertraline)
- Prozac (fluoxetine)
- Celexa (citalopram)
Serotonin & Norepinephrine Reuptake Inhibitors (SNRIs)
SNRIs work similarly to SSRIs but target both serotonin and norepinephrine reabsorption. Serotonin influences mood, while norepinephrine plays a bigger role in energy and focus.²
Commonly prescribed SNRIs include:
- Pristiq (desvenlafaxine)
- Cymbalta (duloxetine)
- Effexor XR (venlafaxine)
Tricyclic Antidepressants (TCAs)
TCAs represent an older generation of antidepressant. Like SSRIs and SNRIs, they block serotonin and norepinephrine reabsorption, but they also affect other receptor types, including cholinergic, muscarinic, and histamine. Since these raise the likelihood of more intense side effects, TCAs are usually only prescribed after SSRIs or SNRIs haven’t worked well.³
Commonly prescribed TCAs include:
- Elavil (amitriptyline)
- Norpramin (desipramine)
- Anafranil (clomipramine)
- Silenor (doxepin)
Monoamine Oxidase Inhibitors (MAOIs)
MAOIs were among the earliest medications developed for depression. They work by slowing the enzymes responsible for breaking down serotonin, norepinephrine, and dopamine. However, they come with a long list of dietary and drug interactions, making careful monitoring essential.⁴
MAOIs may still be prescribed if SSRIs or SNRIs don’t produce results.
Commonly prescribed MAOIs include:
- Marplan (isocarboxazid)
- Nardil (phenelzine)
- Emsam (selegiline)
- Parnate (tranylcypromine)
Other Potential Medications for Depression
Beyond the categories listed above, prescribers sometimes turn to other medications, particularly for specific symptom profiles or when SSRIs and SNRIs haven’t been effective.
Alternative medications for depression include:
- Wellbutrin (bupropion): Targets norepinephrine and dopamine, approved for both major depression and seasonal affective disorder.⁵
- Trazodone: Commonly prescribed for insomnia, trazodone boosts serotonin availability similarly to an SSRI, though it can cause dizziness, drowsiness, or stomach upset.⁶
- Remeron (mirtazapine): Falls under the NaSSA category (noradrenaline and specific serotonergic agents), increasing serotonin, norepinephrine, and noradrenaline levels.⁷
- Auvelity (bupropion and dextromethorphan): Dextromethorphan, typically used as a cough suppressant, has recently shown effectiveness for major depressive disorder when paired with bupropion.⁸
This is not an exhaustive list, and your psychiatric provider will discuss all your options with you during your appointments.
Medication as Part of a Larger Depression Treatment Plan
Medication alone can reduce depressive symptoms for many people, but pairing it with therapy tends to lead to more effective depression treatment overall. One meta-analysis found that combining the two roughly doubled treatment effectiveness compared to either approach on its own. Experts suspect this is largely because medication and therapy work on depression from different angles, one addressing brain chemistry and the other reshaping negative thought patterns.⁹
How Long Will It Take the Antidepressant to Start Working?
Most antidepressants take four to eight weeks to show noticeable effects, and you might start noticing certain symptoms resolve before others. For instance, you might start sleeping better before you notice a shift in your mood. That’s a completely normal part of the process, so it’s important to stay patient and stick with it.
That said, if you haven’t noticed any improvement after eight weeks, or symptoms start returning after initially improving, you should tell your provider. They may adjust your dose or suggest trying a different medication.¹⁰ This is one of the benefits of seeking care with New Directions: We schedule regular check-ins and actively monitor side effects with you, providing support if you need to make a change.
Common Side Effects of Depression Medication
Side effects vary by medication class, and most are mild and tend to ease over time. Your prescriber should walk you through what to expect before you start anything new. If a side effect becomes bothersome, don’t wait to bring it up. There may be ways to manage it, or your provider might adjust your dose or switch you to something else.
Commonly reported side effects of antidepressants include:¹¹ ¹²
- Drowsiness
- Blurred vision
- Dizziness
- Headache
- Dry mouth
- Fatigue
- Nausea
- Sexual side effects
- Sleep disturbances
- Weight changes
- Tremors
Antidepressants & Risk of Suicide
Most antidepressants carry a Boxed Warning, the FDA’s most serious safety designation. This reflects research showing a small increased risk of suicidal thoughts or behaviors in people under 25 taking certain antidepressants.¹³ This is why we so strongly recommend attending therapy alongside taking medication. Our collaborative teams take safety incredibly seriously, scheduling regular follow-up appointments, education our clients on their medication, and always being available if a more urgent need for care arises.
If you or someone you care about shows increased suicidal thinking or behavior after starting a new medication, contact your provider right away or seek immediate help.
If you are feeling suicidal or experiencing a mental health crisis, please reach out for immediate support by contacting your local emergency services, visiting your local emergency room, or calling/texting the National Crisis Hotline at 988.
How to Get the Most Out of Your Antidepressant
An antidepressant likely won’t resolve every symptom, but it should make a real difference in your ability to function and experience a more full range of emotion again. Consistency and patience go a long way, along with staying in regular communication with your provider about any side effects or concerns.
Here are a few ways to get the most from your antidepressant medication:¹⁴
- Stick to a consistent schedule: Taking your dose at the same time daily helps build the habit and reduces missed doses.
- Track your experience: Note changes in mood, symptoms, and side effects as they happen, and bring that information to appointments so your provider has a clear picture of how it’s going.
- Give side effects time: Many effects ease up as your body adjusts to the medication.
- Pair it with therapy: Combining medication with therapy tends to produce stronger outcomes for most people dealing with depression.
- Keep talking to your provider: Report any concerning side effects or lack of improvement so they can adjust your treatment accordingly.
- Steer clear of alcohol and drugs: These substances can counteract your medication’s effectiveness and worsen depression over time.
What If My Antidepressant Isn’t Working?
Many people find relief through antidepressants, but for some, even trying multiple medications doesn’t help. We call this difficult-to-treat depression. However, there are other options when medication isn’t successful in treating depression symptoms.
There are currently two FDA-approved alternative treatments when medication hasn’t worked for depression:
- Transcranial magnetic stimulation (TMS): A safe, low-risk procedure using magnetic pulses to stimulate underactive brain regions tied to depression.
- Spravato®: The first FDA-approved esketamine nasal spray for difficult-to-treat depression, working by boosting glutamate activity and neurotransmitter communication in the brain.
How New Directions Mental Health Can Help
You and your loved ones deserve mental health care that’s both comprehensive and easy to access. Our clinics across Pittsburgh, Monongahela, Wexford, and the surrounding area offer therapy, medication management, and alternative treatments like TMS and Spravato® for anyone seeking depression treatment.
Ready to get started? Call 724.374.7414 to learn more or schedule your first appointment today.
Sources:
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- Serotonin and norepinephrine reuptake inhibitors (SNRIs). (2025). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/snris/art-20044970
- Tricyclic Antidepressants. (2023). Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/25146-tricyclic-antidepressants
- Patel P, Saadabadi A. Monoamine Oxidase Inhibitors (MAOIs). (2026). Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK539848/
- Bupropion (Wellbutrin). (2024). National Alliance on Mental Illness. https://www.nami.org/treatments-and-approaches/mental-health-medications/types-of-medication/bupropion-wellbutrin/
- Fagiolini, A., Comandini, A., Catena Dell’Osso, M., & Kasper, S. (2012). Rediscovering trazodone for the treatment of major depressive disorder. CNS drugs, 26(12), 1033–1049. https://doi.org/10.1007/s40263-012-0010-5
- Jilani TN, Gibbons JR, Faizy RM, et al. Mirtazapine. (2024). Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519059/
- Khabir, Y., Hashmi, M. R., & Ali Asghar, A. (2022). Rapid-acting oral drug (Auvelity) for major depressive disorder. Annals of medicine and surgery (2012), 82, 104629. https://doi.org/10.1016/j.amsu.2022.104629
- Cuijpers, P., Sijbrandij, M., Koole, S. L., Andersson, G., Beekman, A. T., & Reynolds, C. F., 3rd (2014). Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis. World psychiatry : official journal of the World Psychiatric Association (WPA), 13(1), 56–67. https://doi.org/10.1002/wps.20089
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- Antidepressants: Get tips to cope with side effects. (2019). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20049305
- Antidepressants for children and teens. (2022). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/teen-depression/in-depth/antidepressants/art-20047502
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