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Treatment-resistant depression

Medication strategies

If you've already tried an antidepressant and it didn't work, don't lose hope. You and your physician simply may not have found the right dose, medication or combination of medications that works for you. Here are some medication options that your doctor may discuss with you:

  • Give your current medications more time. Antidepressants and other medications for depression typically take four to eight weeks to become fully effective and for side effects to ease up. For some people, it takes even longer.
  • Increase your dose, if indicated. Because people respond to medications differently, you may benefit from a higher dose of medication than is usually prescribed. Ask your doctor whether this is an option for you — don't change your dose on your own as several factors are involved in determining the proper dose.
  • Switch antidepressants. For a number of people, the first antidepressant tried isn't effective. You may need to try several before you find one that works for you.
  • Add another type of antidepressant. Your doctor may prescribe two different classes of antidepressants at the same time. That way they'll affect a wider range of brain chemicals linked to mood. These chemicals are neurotransmitters that include dopamine, serotonin and norepinephrine.
  • Add a medication generally used for another condition. Your doctor may prescribe a medication that's generally used for another mental or physical health problem, along with an antidepressant. This approach, known as augmentation, may include antipsychotics, mood stabilizers, anti-anxiety medications, thyroid hormone or other drugs.
  • Consider pharmacogenetic testing. These tests check for specific genes that indicate how well your body can process (metabolize) a medication or how your depression might respond to a particular medication based on additional factors. Currently, pharmacogenetics tests are not a sure way to show if a medication will work for you, but these tests can provide important clues for treatment, particularly in people who have many side effects or have had poor results with certain medications. These tests are not always covered by insurance.