Antidepressants are widely used and widely misunderstood. This guide explains, in plain terms, what they do and do not do. It is general information only, not medical advice; decisions about medication should always be made with a doctor.
What they do
Antidepressants are medicines that help correct some of the chemistry and signalling in the brain that are involved in mood. The most common types, including the group known as SSRIs, act on brain messengers such as serotonin that play a part in how we feel. For many people with moderate to severe depression or anxiety conditions, they can ease symptoms enough to make daily life, and other treatments such as therapy, more manageable.
What they are not
Antidepressants are not happy pills, and they do not create false happiness or change who you are. They do not solve life problems, and they work best alongside other support such as therapy, good sleep, activity, and connection. They are not, for most people, addictive in the way that some other substances are, though stopping them suddenly can cause unpleasant effects, which is why changes are made gradually and with a doctor.
How long they take
One of the most important things to know is that antidepressants do not work straight away. They usually take about two to six weeks to begin to help, and the full effect can take longer. This is why it is important not to give up too early, and not to stop the moment you feel better. Many people stop too soon and the symptoms return.
Side effects
Like all medicines, antidepressants can have side effects, which are often mild and tend to settle in the first couple of weeks. They differ from person to person and between medicines. If side effects are troubling, the answer is to talk to the prescriber, who can adjust the dose or try a different option, rather than to stop suddenly on your own.
Coming off them
When the time is right to stop, it is done slowly and with medical guidance, by reducing the dose in steps, to avoid the unpleasant effects that sudden stopping can bring. Never stop a prescribed antidepressant abruptly on your own. The decision about when and how to stop belongs with you and your doctor together.
A note for our context
In many communities here, there is fear and stigma around mental health medicines, and people worry they will become dependent, lose their mind, or never be themselves again. These fears are understandable but largely unfounded for antidepressants used as prescribed. Cost and supply can be real challenges, so it is worth discussing affordable options with the prescriber. Used properly, with medical guidance, these medicines help many people recover. Our medications guide has more detail, and any decision should be made with a doctor.
Sources
- Cipriani, A., et al. (2018). Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: A systematic review and network meta-analysis. The Lancet, 391(10128), 1357-1366.
- National Institute for Health and Care Excellence. (2022). Depression in adults: treatment and management (NICE guideline NG222).
- American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
