Managing Depression with Lexapro, Zoloft, Wellbutrin, and Prozac: A Guide to Expectations

18% of individuals with ADHD are impacted by depression, with those individuals having a risk of developing depression that is 2.5 times higher than that of the general population. Around half of all depressive cases are rated as severe to extreme by both the patient and clinician, which emphasizes the importance of early detection and intervention.

The best course of action is to seek guidance from a mental health professional who can tailor their evaluation and treatment approach to your specific situation. However, research shows that antidepressants can be incredibly beneficial in treating depression in the majority of cases. This is especially true when cognitive therapy is also used in conjunction with medication.

There are seven primary medication classes used to treat depression, and they tend to have similar response rates of roughly 70%. The choice of medication largely depends on whether or not the medication causes side effects and if one type of medication is more likely to effectively treat associated symptoms.

Fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), and paroxetine (Paxil) are all in the SSRI group of antidepressants, which tend to be effective for individuals with both anxiety and depression. Wellbutrin or Effexor XR are more activating antidepressants, which can help those who struggle with lethargy. Cymbalta is a common choice for those who suffer from chronic pain, and Brintellix is frequently prescribed for patients with cognitive decline.

Aripiprazole (Abilify), an ADHD stimulant medication (amphetamine or methylphenidate), thyroid hormone, lithium, or a second antidepressant from a different class are all possible "augmenting agents" that are sometimes used in combination with antidepressants when an individual is experiencing some but not full remission.

It is important to remember that antidepressants do not work immediately like ADHD stimulant medication. The first two weeks of taking the medication will typically consist of more side effects than benefits, with little noticeable depression symptom relief. However, the two main symptoms of depression, irritability and crying spells, will usually subside. By the 10-week mark, you should be seeing what the medication can do, and if you are not experiencing full remission, you should discuss augmenting agents with your clinician.

The length of time an individual should stay on medication for depression is dependent on various factors and should be discussed with a doctor. Studies have shown that individuals who have experienced full remission should stay on medication for at least one year, as early termination of medication can lead to a high likelihood of relapse.

All of the mood disorders are what we call “kindling illnesses” — that is, the more episodes you have, the more you will have in the future and the more severe they will get with each repetition. Statistically, if you immediately treat each depressive episode for a full year, you should expect 3 episodes in your whole life. If, on the other hand, you do not treat each episode completely or stop as soon as  you as you feel better, you can expect 17 more depressive episodes through your life with each one becoming progressively more impairing, more painful, longer, and closer together.

As with any medication that works in the brain, it’s not a good idea to stop taking antidepressants suddenly. Some antidepressants can cause withdrawal-like symptoms and can worsen depression when stopped suddenly. If you’re thinking about ceasing your antidepressant medications, speak with your doctor about it and then taper off slowly according to their guidance.

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