Medication for depression isn’t an instant cure, but it can make a big difference in treating depressive symptoms. Before being prescribed depression medication, a psychiatric provider will ask you questions to understand your medical history, past experiences with medication, and your family history.

It might take a few tries to find the right medication and dose, and your prescriber will work with you to track your symptoms and side effects to ensure you’re on the right medication for your needs.

What Are Antidepressants?

Antidepressants work by increasing the brain’s ability to produce and absorb neurotransmitters, chemicals that impact mood and energy levels. Most antidepressants target serotonin, norepinephrine, or dopamine, which have been found to be deficient for many people with depression.

Selective Serotonin Reuptake Inhibitors (SSRIS)

Selective Serotonin Reuptake Inhibitors (SSRIS) are often where psychiatric providers start when prescribing medication for depression, because they tend to work well for many people and have few risks and side effects. SSRIs work by blocking the reabsorption (or “reuptake”) of serotonin, leaving more for receptors in the brain to intake and process.¹

Common SSRIs include:

• Lexapro (escitalopram)
• Zoloft (sertraline)
• Prozac (fluoxetine)
• Celexa (citalopram)

Serotonin & Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs block the reabsorption of both serotonin and norepinephrine, leaving more of these chemicals free to act on receptors in the brain. While serotonin is correlated with mood, norepinephrine is more closely linked with energy and focus.²

Common SNRIs include:

• Pristiq (desvenlafaxine)
• Cymbalta (duloxetine)
• Effexor XR (venlafaxine)

Tricyclic Antidepressants (TCAs)

Tricyclic antidepressants (TCAs) are an older class of medication which also work by blocking the reabsorption of serotonin and norepinephrine in the brain. However, they block other receptors, such as cholinergic, muscarinic, and histamine, leading to more risk of side effects. This is the reason TCAs are typically the second-line treatment for people who don’t respond well to SSRIs or SNRIs.³

Common TCAs include:

• Elavil (amitriptyline)
• Norpramin (desipramine)
• Anafranil (clomipramine)
• Silenor (doxepin)

Monoamine Oxidase Inhibitors (MAOIs)

MAOIs are one of the original medications used for treating depression. They work by limiting the activity of certain enzymes that metabolize neurotransmitters like serotonin, norepinephrine, and dopamine. However, MAOIs have an extensive list of food and drug interactions, making them inconvenient or dangerous to take without extreme caution.⁴

They could still be prescribed if SSRIs or SNRIs are ineffective.

Common MAOIs include:

• Marplan (isocarboxazid)
• Nardil (phenelzine)
• Emsam (selegiline)
• Parnate (tranylcypromine)

Other Potential Medications for Depression

While many of the medications prescribed for depression are in one of the categories listed above, a psychiatric provider might prescribe a different medication for certain depression symptoms, or if someone doesn’t respond well to SSRIs or SNRIs.

Other medications used for depression include:

• Wellbutrin (buproprion): Wellbutrin targets norepinephrine and dopamine and is approved for treating major depression and seasonal affective disorder in adults.⁵
• Trazodone: Often used to treat insomnia, trazodone increases serotonin access in the brain similarly to an SSRI. However, common side effects include dizziness, drowsiness, and diarrhea.⁶
• Remeron (mirtazapine): Remeron is in a class of medications called noradrenaline and specific serotonergic agents (NaSSAs), increasing serotonin, norepinephrine, and noradrenaline in the brain.⁷
• Auvelity (bupropion and dextromethorphan): Auvelity is a newer medication, combining two different drugs that have been used to treat depression for years. Dextromethorphan is primarily used as a cough suppressant, but has been shown to treat major depressive disorder in combination with buproprion.⁸

Medication as Part of a Larger Depression Treatment Plan

Medication can significantly lower the symptoms of depression for many people. However, medication can be more successful when it’s paired with therapy. One meta-analysis determined that the combination of therapy and medication made depression treatment about twice as effective as either on its own. It also determined that medication and therapy work differently on the brain, with medication targeting neurotransmitters and therapy helping to change negative thought patterns.⁹

How Long Will It Take the Antidepressant to Start Working?

Antidepressants typically take somewhere between one to two months to start working, and you might notice certain symptoms start to improve before others. For instance, you may start sleeping better before you notice any improvement in your mood. This is perfectly normal, and it’s important to remain patient.¹⁰

However, if you don’t notice any relief from your depressive symptoms after eight weeks, or you notice symptoms coming back over time, tell your provider right away. They may up your dosage or recommend taking another medication.

Common Side Effects of Depression Medication

Each class of antidepressants has different possible side effects. Most are mild, and may get better over time, but your prescriber should tell you about any potential impacts you might experience before starting a new medication. If you notice any side effects that really bother you, let your provider know as soon as possible. They might have ideas for how to mitigate these side effects, or they may change your dose or suggest a new prescription instead.

Common side effects of antidepressants can include:^11,12

• Drowsiness
• Blurred vision
• Dizziness
• Headache
• Dry mouth
• Lowered energy
• Nausea
• Issues with sexual function
• Problems with sleep
• Weight gain
• Tremors

Antidepressants & Risk of Suicide

Most antidepressants come with a Boxed Warning (formerly called a Black Box Warning), the strongest safety warning assigned by the FDA. This is because several antidepressants can lead to a heightened risk of suicidal thoughts and behaviors for a small number of people under 25.¹³

You should always talk to your provider if you notice an increase in suicidal thinking or behaviors in you or a loved one after beginning a new medication.

If you are feeling suicidal or experiencing a mental health crisis, please reach out for immediate support by contacting your local emergency services, visiting your local emergency room, or calling/texting the National Crisis Hotline at 988.

How to Get the Most Out of Your Antidepressant

While an antidepressant might not cure all your symptoms, it should make a significant difference in how you feel. Stick to taking your prescribed dose consistently and apply a little patience, and don’t be afraid to talk to your prescriber about any unwanted side effects you experience.

Here are a few tips for getting the most out of your antidepressant medication:¹⁴

• Take your prescribed dose at the same time every day: Incorporate your medication into your daily routine to ensure you don’t skip a dose.
• Track your mood, symptoms, and side effects: Write down any changes you experience in real time and bring this information with you to your appointments so your provider can determine whether the medication is working effectively.
• Be patient if you notice any side effects: Many side effects subside over time as your body gets used to the medication.
• Also try therapy: Combining therapy and medication can lead to more success for many people with depression.
• Keep an open dialogue with your provider: Tell your prescriber about any adverse effects you experience or if your symptoms don’t improve over time. They may recommend upping or changing your dose, or trying a new medication altogether.
• Avoid drugs and alcohol: While it can be tempting to cope with depression by using alcohol and other substances, they can worsen depression and make it harder to treat.

What If My Antidepressant Isn’t Working?

Antidepressants can be incredibly effective at reducing symptoms of depression for many. However, some people don’t find relief even after trying multiple medications, a condition we call difficult-to-treat depression. In these cases, there is still hope.

The FDA has approved a few different treatments for people who don’t respond to antidepressants, including:

• Transcranial magnetic stimulation (TMS): TMS uses magnets to stimulate areas of the brain that may be underactive due to depression. It has very few side effects and is an incredibly safe procedure.
• Spravato®: Spravato® is the first FDA-approved esketamine nasal spray for hard-to-treat depression. It targets glutamate activity in the brain, boosting neurotransmitter communication.

How Northeast Health Services Can Help

You deserve convenient, comprehensive mental health care for yourself and your loved ones. Our clinics across Massachusetts offer therapy, medication, and alternative treatments like TMS and Spravato® for those looking for depression treatment.

If you’re ready to start treatment, you can call 508.794.8711 to learn more or schedule your first appointment today.

 

 

Footnotes:

1. Edinoff, A. N., Akuly, H. A., Hanna, T. A., Ochoa, C. O., Patti, S. J., Ghaffar, Y. A., Kaye, A. D., Viswanath, O., Urits, I., Boyer, A. G., Cornett, E. M., & Kaye, A. M. (2021). Selective Serotonin Reuptake Inhibitors and Adverse Effects: A Narrative Review. Neurology international, 13(3), 387–401. https://doi.org/10.3390/neurolint13030038
2. Serotonin and norepinephrine reuptake inhibitors (SNRIs). (2025). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/snris/art-20044970
3. Tricyclic Antidepressants. (2023). Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/25146-tricyclic-antidepressants
4. Patel P, Saadabadi A. Monoamine Oxidase Inhibitors (MAOIs). (2025). Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK539848/
5. Bupropion (Wellbutrin). (2024). National Alliance on Mental Illness. https://www.nami.org/treatments-and-approaches/mental-health-medications/types-of-medication/bupropion-wellbutrin/
6. Fagiolini, A., Comandini, A., Catena Dell’Osso, M., & Kasper, S. (2012). Rediscovering trazodone for the treatment of major depressive disorder. CNS drugs, 26(12), 1033–1049. https://doi.org/10.1007/s40263-012-0010-5
7. Jilani TN, Gibbons JR, Faizy RM, et al. Mirtazapine. (2024). Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519059/
8. Khabir, Y., Hashmi, M. R., & Ali Asghar, A. (2022). Rapid-acting oral drug (Auvelity) for major depressive disorder. Annals of medicine and surgery 82, 104629. https://doi.org/10.1016/j.amsu.2022.104629
9. Cuijpers, P., Sijbrandij, M., Koole, S. L., Andersson, G., Beekman, A. T., & Reynolds, C. F., 3rd (2014). Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis. World psychiatry : official journal of the World Psychiatric Association (WPA), 13(1), 56–67. https://doi.org/10.1002/wps.20089
10. Antidepressants. (2025). Medline Plus. https://medlineplus.gov/antidepressants.html
11. Antidepressants. (2025). Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/9301-antidepressants-depression-medication
12. Antidepressants: Get tips to cope with side effects. (2019). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20049305
13. Antidepressants for children and teens. (2022). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/teen-depression/in-depth/antidepressants/art-20047502
14. Antidepressants: Selecting one that’s right for you. (2022). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046273