- Increasing the dose of the antidepressant you're on
- Continuing at the same dose and adding a second drug: either another antidepressant (combination therapy) or add another type of drug (augmentation therapy)
- Switching, which involves gradually stopping the first drug and starting a second
- Starting psychotherapy, if you're not already attending sessions
"My hope for every patient is that major depression remits as soon as possible with few side effects," says George I. Papakostas, MD, an assistant professor of psychiatry at Harvard Medical School.
- Tolerability: How severe are the side effects, and how much trouble are they causing?
- Time: How long have you been on medication?
- Degree of improvement: Have the depression symptoms improved in proportion to how long you've been on medication?
Higher doses of antidepressants
If you're doing well with an antidepressant but there's room for improvement, increasing the dosage may be a smart move, especially if you're not experiencing side effects. If you don't notice a significant response after six weeks at a higher dosage, switching to another antidepressant is probably the most appropriate therapeutic intervention, says Kenneth Robbins, MD, clinical associate professor of psychiatry at the University of Wisconsin–Madison.
Some of the medications doctors may prescribe include Wellbutrin, lithium, thyroid hormone, or Provigil.
Patients who want to stop taking antidepressants should do so gradually, with their doctor or psychologist's guidance. However, fear of suicidal tendencies and fear of addiction should not be factors.