Antidepressants in the category of selective serotonin reuptake inhibitors (SSRIs) are useful medications in the treatment of depression. They are often chosen because of their effectiveness in treating the symptoms of depression, and because of their relatively low side effect risk.

When any of my patients in or near El Paso, Albuquerque, or Las Cruces is started on an antidepressant such as Paxil or Zoloft, it’s common for them to worry about the medication’s effectiveness. They might wonder what treatment route we will take for their depression if none of the SSRIs we try seem to be working for their symptoms. Or, as patients with depression begin to feel better on their treatment, I hear worried comments like, “Okay, my depression seems to be controlled with Prozac. But what will I do if the Prozac stops working?”

If I am working with patients and they begin to experience reduced effectiveness with their current antidepressant treatment, I understand their concern. When they have had relief from depression symptoms like exhaustion, irritability, and lack of motivation, it’s troubling that they may come back. I always explain to patients that there are effective adjunct medications, or helper secondary medications, that can be added to their antidepressant medication to tackle their depression more effectively.

When Adjunct Medications Are Prescribed in the Treatment of Depression

A spouse, a close family member or a friend may be the first to notice depression symptoms are interfering with my patient’s work life, relationships with spouse and kids, or with their ability to engage in the community. When a patient is started on antidepressant medication, the goal is to reduce their depression symptoms while also minimizing any bothersome medication side effects. As the patient starts to feel better, they may notice an increase in energy, a decrease in sadness and irritability, and fewer aches and pains. If the patient feels that their symptoms have improved and that the work, family, or social challenges that prompted them to seek help for depression are now overcome, they will continue on the dose of antidepressant that is working for them.

Sometimes, though, an antidepressant alone can’t offer the relief from depression symptoms a person expects. You and your behavioral health provider may determine that a medication in addition to your antidepressant is needed under two distinct circumstances:

• At the beginning of your treatment, when you and your provider are trying to find the correct medication and dose for your depression, or
• Later in your treatment, when an antidepressant has been working for your depression symptoms for a period of time, and then becomes less effective.

At our practice, when talking with a new patient who is being seen for depression symptoms, we discuss what symptoms are particularly troubling to the patient, and what side effects the patient hopes to avoid. This discussion informs what medication and dose we recommend the patient begins on. I set expectations that it can take several weeks to see full improvement of symptoms. If this period has passed, and the patient isn’t getting relief from his or her depression, it’s often time to try a different antidepressant. If the patient doesn’t show the hoped-for improvement with this second medication, I might suggest adding in an adjunct medication.

In a different scenario, some of our patients have been responding very well to their antidepressant, like Prozac or Lexapro, for many years. For a long time, they were satisfied with their improved depression symptoms and their low or absent side effects. Eventually, either the patient or their partner notices an increase in their fatigue, sadness, or other depression symptoms. If possible, I may try to adjust the dose of their current medication. If adjusting the dose of the medication isn’t possible, or we adjust the dose and this isn’t effective, then it can be time to add an adjunct medication to their regimen.

Some Adjunct Medications That May Be Used to Assist in the Treatment of Depression

As we discussed above, adjunct medications are medications that are added to your current antidepressant regimen to help the antidepressant work better. Commonly at our practice we prescribe Rexulti, Abilify, and Seroquel, and when used as adjunct medications, these meds are prescribed in relatively low doses. When used in this way, the dose for Rexulti is 2-3 mg/day, for Seroquel is 300 mg/day, and for Abilify is 5-15 mg/day. These adjunct medications work in a different way in the body than SSRIs do; therefore, the two medications work in concert to overcome depression symptoms for patients.

When you and your behavioral health provider decide to add an adjunct medication like Rexulti, Abilify, or Seroquel to your antidepressant medication, you will both be on the lookout for both new side effects and improvements in your depression symptoms. Like when starting a new antidepressant medication, it may take a dose change or a medication change before you and your provider find the exact adjunct med that helps your antidepressant fight your depression. If you can be patient and communicate your experience and needs to your provider, it will be worth it when your depression is under the best control possible.

For a patient, it can feel very challenging when the first antidepressant you try doesn’t work, or when the antidepressant that had been helping stops working for you. At Upper Valley Behavioral Health, our patients consistently tell us that our friendly, respectful staff and behavioral health experts are easy to communicate with. Open and easy communication with your behavioral health provider makes managing your depression a less overwhelming experience, even when your medication regimen needs to be tweaked.

If you live in or around El Paso, Las Cruces, or Albuquerque and are experiencing depression symptoms that are interfering with your life, please schedule an appointment with us today. Click here for our application for treatment.

Disclaimer: This post is for informational purposes only. It does not replace instructions from your licensed prescriber. Please consult your healthcare provider for guidance on your specific medication regimen.

Tags: antidepressant, mental health, depression, mental health awareness, antidepressant medication, depression meds, depression relief, depression help, depression treatment, therapy, depression, mental health matters, depression help, adjunct medications, meds not working

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