Finding the right antidepressant or anti-anxiety medication (or combination of medications) requires a steady stream of diligence — a level of persistence that can quickly dry up if side effects start to make an appearance.
“Everyone’s brain and body responds to and processes medications differently, so getting on the right medication regimen can be a frustrating process for some people,” Melissa Shepard, board-certified psychiatrist and assistant professor at Johns Hopkins School of Medicine, told HuffPost. “The most frustrating part being we don’t always know why.”
There are some clues doctors can use to try to predict how someone will personally respond to a prescription — the symptoms they’re experiencing, how they’ve responded to other medications, and on occasion, certain types of genetic testing — but even with these clues, for many people it’s still a matter of trial and error.
“Trying to predict the effect of one medication on a particular individual is nearly impossible, so we have to make decisions based on what we know about the patient and the medication to try and yield the best chance for a successful treatment,” said Shane Rau, vice president and medical director for the telepsychiatry practice Array Behavioral Care.
Experiencing side effects doesn’t always mean stopping or changing your medication is necessary. But if you feel like something’s off, these common side effect scenarios can help you suss out what to do next.
You feel better right away (but it doesn’t last)
Most currently available medications do their thing by indirectly increasing the levels of neurotransmitters thought to play a role in mood disorders and anxiety, such as serotonin, norepinephrine or dopamine — but mood disorders and anxiety are more than just the ups and downs of these neurotransmitters.
“Sometimes, changes that occur right after the initiation of a med (or change in med dose) can produce effects on mood or anxiety that are transient,” said Erik Vanderlip, board-certified psychiatrist and family physician at the Pacific Premier Group in Portland, Oregon. “We still don’t know why this may be the case for some individuals, but there are a few theories.”
There are different patterns of depression and anxiety, and sometimes one pattern can respond well initially to something but then get worse “because we haven’t matched the right medication to the right pattern,” Vanderlip explained.
Someone struggling with a bipolar pattern to their depression, for instance, may have some initial improvement on their medication that doesn’t last and may need something that’s more a mood stabilizer than an antidepressant.
Similarly, concurrent taking of substances (like alcohol) or medical conditions that can mimic depression (low thyroid disorders) can sometimes explain why a transient response can lessen over time.
“Just taking a medication is often not enough to achieve optimal recovery for many,” Vanderlip said. “Staying on top of your physical health (sleep, exercise, nutrition, other conditions) and avoiding substances are all part of maintaining your mental health.”
Then there’s the placebo effect — the belief that a medication will work — due to the fact that all medications have meaning to the person taking them.
“The placebo effect isn’t bad in and of itself, but many people in clinical trials of new medications respond to placebo pills in part because having hope in something can innately be helpful for mental health,” Vanderlip said.
You experience side effects that don’t go away
Some people are natively more sensitive to medication side effects than others. “There are often unknown factors at play, but for some, it may be because they metabolize the medications more slowly, so they have a tendency to build up in their system,” Vanderlip said.
If this is a repeated problem for you, some forms of genetic testing that examine how your liver processes these…
Read More: 7 Signs Your Mental Health Medication Isn’t Working The Way It Should