Most people manage their major depressive disorder (MDD) symptoms with the help of antidepressant medications. But only a few people are benefitted by the antidepressant medications as they are managed to ease the symptoms of major depressive disorder. On the other hand, even though using the antidepressants for a long time and changing the medication as per the doctor suggested the results are not getting better in some people. In some cases, people who are suffering from a major depressive disorder are able to reduce the symptoms, but they are coming back again after stop using the medication for a few days.
Have a word with your physician if you think your symptoms aren’t improving and experiencing things such as
- Sadness
- Low self-esteem
- Poor sleep or difficulty in sleeping
Your medication isn’t effective that is why you are not getting adequate relief from your symptoms. This article will help you to find out the best questions you can ask your healthcare provider in order to find the right treatment for your mental health condition.
Am I taking my medication in the right way?
Many people who are suffering from major depressive disorder (MDD) are not taking the medication in the way their physician prescribed and skipping doses will have a negative impact on their condition.
If you think your medications have failed to improve your mental health condition, once check the dosage you are taking and then question yourself whether you are taking the right dosage before consulting your physician. Because it will be your fault if you didn’t follow your physician’s instructions properly.
Please bear in mind that you shouldn’t stop taking your medication suddenly or without taking your physician to advise as it may lead to severe complications. If you are unable to bear the side effects, call your doctor immediately and he will decide which is the best suitable medication for you or if the problem lies in the dosage of your medication, your physician will make a small change to your dosage or he may recommend you to use another drug.
Am I taking the right drug?
There are various types of antidepressant medications available in the market and are approved by the food and drug administration to treat the major depressive disorder (MDD). Your physician may recommend you to take Selective serotonin reuptake inhibitors (SSRIs) because these are your doctor’s first choice drugs as they tend to cause fewer side effects. If you are taking Prozac, Zoloft, Paxil, Lexapro, Luvox, Celexa, viibrid, and Brintellix all these come under SSRIs. Doctors often recommend these drugs to their patients as the side effects of these medications are low when compared to other drugs.
If SSRIs are unable to improve your condition, then your doctor may suggest you take serotonin-norepinephrine reuptake inhibitors (SNRIs). These antidepressants work by raising the serotonin levels in the body which is a feel-good chemical and SNRIs include Effexor XR, Pristiq, Savella, Cymbalta, Effexor, Fetzima, Irenka, and Khedezla. SNRIs are also called Selective serotonin-norepinephrine reuptake inhibitors (SSNRIs). SNRIs also work on another neurotransmitter known as norepinephrine. It is also a feel-good chemical like serotonin and norepinephrine.
If both the SSRIs and SNRIs are not showing any positive results, then your doctor may recommend you to use atypical antidepressants because these antidepressants can change the levels of neurotransmitters such as
- Serotonin
- Dopamine
- Norepinephrine
Bupropion, vortioxetine, mirtazapine, vilazodone, nefazodone, and trazodone all these drugs can treat depression and are approved by the food and drug administration (FDA). In recent times, food and drug administration approved a drug that belongs to atypical antidepressants to treat depression and it is called esketamine. The side effects associated with atypical antidepressants include dry mouth, dizziness or lightheadedness, insomnia or difficulty in sleeping, constipation, diarrhea, increase in appetite, weight gain, nausea, and sexual side effects such as erectile dysfunction in men (unable maintain an erection).
If your condition is not getting better even after using all the SSRIs, SNRIs, and atypical antidepressants then your healthcare provider may suggest you to try tricyclic antidepressants. Amitriptyline, amoxapine, desipramine, doxepin, imipramine, nortriptyline, protriptyline, and trimipramine all these drugs belong to tricyclic antidepressants and are approved by the food and drug administration to treat the major depressive disorders.
Tricyclic antidepressant side effects include drowsiness, blurred vision, urine retention, weight loss, tremor, dry mouth, excessive sweating, constipation, increased appetite leading to weight gain, drop in blood pressure when moving from sitting to standing, which can cause lightheadedness, and sexual problems such as difficulty achieving an erection, delayed orgasm or low sex drive.
It’s not an easy task for a physician to find you a suitable antidepressant medication for your problem. People have to try different types of antidepressant medications before finding a suitable drug for them. Your physician may change your medication if the first drug is unable to ease the symptoms of your mental health condition. This treatment plan will definitely test your patience levels as the medication prescribed by your physician will not show its effects after using it for two to three weeks. In rare cases, the drug you are taking doesn’t show any effects even after 8 weeks.
There is only one way to find a suitable drug for your condition is to take the cytochrome P450 (CYP450) test. This will give a clear picture of your gene variations and your physician may prescribe you the antidepressants depending on the result of this test.
Am I taking the correct dosage?
To examine if the antidepressant actually functions your physician may suggest you begin using minimum doses. The main objective of your physician is to minimize your symptoms by suggesting to you the right dosage without resulting in any severe consequences. This ensures that your depression is minimized in an optimal manner. We would advise you to keep a track on the intake of dosage and consult your doctor on a timely basis.
Treatment alternatives that can be considered
For treating major depressive disorder using antidepressant drugs is not the only treatment alternative. Studies indicate that going through cognitive behavioral therapy (CBT) which is a form of psychotherapy is advisable. When a patient suffering from major depressive disorder undergoes cognitive behavioral therapy, they work with the specialist to assist them in recognizing dangerous patterns of thinking and discover more efficient alternatives to handle the difficulties in life. Instead of opting for only antidepressants or only cognitive behavioral therapy, studies have proven that going through cognitive behavioral therapy along with the usage of antidepressant drugs gives optimal results.
Another alternative the physicians opt for when the antidepressants are not curing the symptoms in an efficient manner is Vagus nerve stimulation (VNS). A wire is attached to the vagus nerve that begins at the back of your neck and ends at your brain in vagus nerve stimulation (VNS). The wire is connected to a device that is similar to a pacemaker that transfers electric impulses to your brain, which in turn alleviates the symptoms of depression.
Electroconvulsive therapy (ECT) can also be considered as an alternative in cases of serious depression. However, this is not the treatment that was once practiced on patients in mental asylums, which was called as shock therapy. Electroconvulsive therapy makes use of the electric current in an effort to change the chemistry of the brain, which is a risk-free and efficient treatment for depression.
Some other issues contributing to the symptoms of major depressive disorder (MDD):
Depressive disorders can be deteriorated by several factors. This may be due to many situations or conditions that you are experiencing in your life which makes you melancholic and lonely and the drugs you are using may not be sufficient to reduce the symptoms of your problem.
We would advise you to take a look of other factors that can contribute to depression which are mentioned below:
- Death of a family member
- Living alone due to the new job or relocated to the new place
- Unable to maintain the fitness levels or sudden drop in your fitness levels due to irregularity in going to the gym
- Unable to face the challenges in your new job role
- Heavy alcohol or drug use
Are you sure that you are experiencing depression?
It is possible that a different medical condition or the medication that you use might be the reason that you are going through the symptoms of Major Depressive Disorder when you have taken various antidepressants and they haven’t displayed any positive results.
The conditions that can contribute to the symptoms which are similar to the depression are anxiety, heart failure, substance abuse, lupus, obstructive sleep apnea (OSA), Lyme disease, anemia, diabetes, chronic pain, dementia, Parkinson’s disease, stroke, and multiple sclerosis (MS).
Sedatives, opioid pain relievers, birth control pills, high blood pressure medications, and corticosteroids are the drugs that can cause depressive symptoms.
If you are experiencing severe symptoms due to the medication that you are currently taking, change your medication with the help of your doctor.
There is a possibility that you might be experiencing a different mental health condition such as bipolar disorder. In this case, we would advise you to discuss the treatment alternatives with your physician. The treatment for bipolar disorder and mental health condition is distinct from the treatment given for major depressive disorder.
Sirisha B