Depression (medical treatment)
Psychiatry clinic for depressive disorder: diagnosis, medication, dose-adjustment follow-up and relapse prevention.
When to see a psychiatrist
- Depressive symptoms lasting weeks and affecting your daily life.
- Persistent insomnia, weight loss or being unable to work.
- Depression that isn't improving with psychotherapy alone.
- Previous depressive episodes or a family history.
- Thoughts of death or not wanting to carry on: see us without waiting; if it's urgent, the 024 helpline is available 24 hours a day.
Diagnosis isn't just a label
The first consultation aims to pin down exactly what kind of depression this is and what surrounds it: whether there's a history of episodes of elevated mood — which would shift the diagnosis towards bipolar disorder and change the treatment too —, whether there's alcohol use, an underlying medical condition, or a medication that might be contributing. That's why the full medication list is reviewed and, where appropriate, blood tests are requested.
Medication treatment, explained
Antidepressants take between two and four weeks to start showing an effect, and sometimes the first few days bring discomfort that later fades: knowing this in advance prevents people giving up too soon. The dose is adjusted at reviews and, once the episode lifts, treatment is continued for a while to consolidate the improvement: stopping it as soon as you feel well is the most common cause of relapse. When it's time to stop, it's done gradually and under supervision.
Alongside therapy
In moderate and severe depression, combining medication with psychotherapy gives the best results. The two are coordinated, and sleep, physical activity and a gradual return to routine are also worked on.
Frequently asked questions
How long does an antidepressant take to work?
Between two and four weeks before it starts to be noticed, and sometimes the first few days bring side effects that later disappear. Knowing this in advance prevents stopping too soon, which is the most common reason the treatment appears not to work.
I feel well now, can I stop the treatment?
Not on your own initiative. When the episode remits, treatment is maintained for a while to consolidate the improvement; withdrawing it as soon as one feels well is the most frequent cause of relapse. Withdrawal, when the time comes, is done gradually and to a set plan.
Why am I asked whether I have had periods of very high energy?
Because if there have been episodes of euphoria or of needing less sleep, the diagnosis may be bipolar disorder, and that changes the treatment completely. It is a key question that the family sometimes remembers better than the person themselves.
Which antidepressant has the fewest side effects?
It depends on the person: the same drug affects two patients differently. It is chosen by weighing up your symptoms, your age, other conditions and the rest of your medication, and adjusted at follow-up appointments if problems appear. Initial side effects usually settle within the first few days.
Which antidepressant is good for depression?
All first-line options have similar efficacy; the difference lies in their side-effect profile and in what suits you —whether you sleep badly, whether there is associated anxiety, whether there is chronic pain—. That is why prescriptions are not copied: the medicine is prescribed after assessment and followed closely during the first weeks.
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Content reviewed by Dr Klejda Cibuku