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It can be hard to know where to begin if you think you might be depressed. Many people might hesitate to even call what they’re feeling depression. But rest assured: it’s a lot more common than you might think, it doesn’t have to be permanent, and there are many ways to deal with it—including taking medications called antidepressants.
To get depression medication, you first need to schedule an appointment with a healthcare provider who can diagnose you with depression. Read on to learn more about depression, antidepressants, and how to get a prescription for depression medication if you think you need help.
What is depression?
Depression is a treatable mental health condition that includes persistent feelings of sadness, low mood, or loss of interest in everyday life. There are several types of depression, but some universal symptoms you might experience include feeling sad, empty, or irritable, sleeping poorly, having difficulty concentrating, and having low energy (Chand, 2021).
Depression can take many forms, and they are all real and valid. For example:
- You may notice that you feel lower and less happy than you used to.
- You may have had something emotionally difficult to deal with that you never quite felt better after.
- You may have a hard time motivating yourself to do much of anything.
- You might feel panicked, anxious, or irritable.
In many cases, depression is very treatable.
Do I need depression medication?
Recognizing that you’re feeling depressed can be hard, but it’s a crucial first step. Once you’ve realized that you don’t feel quite right and that you want to feel better, check in with your healthcare provider so that they can help you to identify the feeling that you’re having and develop a treatment plan.
Your healthcare provider will likely consider medication if your depressive feelings significantly affect your ability to function in your daily life.
Some people may feel hesitant to try medication to treat depression or fear that they may become “hooked.” But this simply isn’t the case. Instead, medication can be a temporary tool to help you reset and bridge the gap from depression toward a healthier, happier life where your mood can be self-sufficient.
For some people with depression (like those whose depression is a symptom of a larger mental health issue like schizophrenia or bipolar disorder), long-term medication will be a key part of helping them to function comfortably in society.
Studies show that depression medication is most effective when combined with other treatments for depression—such as talk therapy (Rush, 2022).
Getting depression medication
Seeing a licensed care provider is the first step in diagnosing depression and is also a necessary step before getting a prescription for medication.
How to fight depression: 12 ways to cope
Visit with a healthcare provider
A visit with a healthcare provider helps make sure that they understand the problem you’re experiencing so they can prescribe the most appropriate and effective medication for you.
A general practitioner or a doctor specializing in mental health (a psychiatrist) can diagnose depression and prescribe medication to treat it. Psychologists can also recommend a diagnosis of depression, but they can’t prescribe medication.
If you like having an in-person interaction with your provider, you can make an appointment with your healthcare provider. But what about virtual visits? Can a telehealth or online doctor prescribe antidepressants? Yes, they can—so you have the option of having an in-person or a telehealth appointment for receiving a prescription. You can also get online therapy as a treatment for depression.
Telemedicine can be a great, safe, and convenient option if you like the idea of having a visit from the comfort of your home (especially since talking about mental health struggles can be a sensitive topic). Just make sure that you do a little homework to make sure the service is reputable, including checking:
- Does the company employ licensed providers?
- Are they transparent about their pay structure?
- Does the provider take their time during your visit, rather than rushing you through without listening to you speak?
- Does the company offer follow-up appointments with your provider to see how your treatment is going?
Filling the prescription
Antidepressant prescriptions can be easily filled at your local pharmacy or an online pharmacy. Depression medications generally aren’t a specialty item, and most pharmacies have them in stock and available. So, you shouldn’t have to wait longer than usual for your prescription to be filled.
Antidepressants: types, side effects, uses, and risks
When medication is likely to be prescribed
There are a few depression diagnoses that can benefit from treatment with medication (Bains, 2021; Mann, 2022; Munir, 2022):
- Major depressive disorder (MDD): Also known as unipolar depression, MDD symptoms include persistent sadness or guilt or feelings of worthlessness, loss of interest, sleep disruption, weight fluctuation, difficulty concentrating, and suicidal thoughts.
- Generalized anxiety disorder (GAD): Symptoms of generalized anxiety disorder include persistent feelings of irrational fear, excessive worry, and constantly being overwhelmed.
- Bipolar disorder: Depression is one of the central characteristics of bipolar disorder, along with periods of excessive energy highs. Antidepressants may be prescribed along with other mental health medications like mood stabilizers to help manage this condition.
- Post-traumatic stress disorder (PTSD): Symptoms of PTSD include having traumatic flashbacks, sleep problems, irritability, feelings of sadness or guilt, and hypervigilance.
- Obsessive compulsive disorder (OCD): OCD is characterized by ongoing intrusive thoughts (obsessions) and actions or rituals to compensate for the stress brought on by these thoughts (compulsions).
- Premenstrual dysphoric disorder (PMDD): PMDD is the most severe form of premenstrual syndrome and, on a monthly basis, causes feelings of depression, anxiety, volatile mood, or increased irritability that interfere with daily functioning.
Types of depression medication
There are several types of antidepressants. You may try a few before finding the one that works for you. Some of the main antidepressants include (Huecker, 2021; Sheffler, 2021):
Selective serotonin reuptake inhibitors (SSRIs) are a first-line treatment for depression.
They work by prolonging how long serotonin—a brain chemical that works between nerve cells in the brain and regulates your mood—works in your brain. Normally, once serotonin has done its job, it is taken back up into the cells. SSRIs prevent the reuptake of serotonin into the cells, which increases serotonin levels in the brain.
Common SSRIs include:
- Sertraline (Zoloft; see Important Safety Information)
- Fluoxetine (Prozac; see Important Safety Information)
- Escitalopram (Lexapro; see Important Safety Information)
- Paroxetine (Paxil, Brisdelle; see Important Safety Information)
Unlike SSRIs that focus solely on keeping serotonin in your system longer, serotonin and norepinephrine reuptake inhibitors (SNRIs) help keep two brain chemicals—serotonin and norepinephrine—in your system longer. Norepinephrine helps to keep you alert and interested and regulates your mood.
- Duloxetine (Cymbalta; see Important Safety Information)
- Venlafaxine (Effexor; see Important Safety Information)
Tricyclic antidepressants, or TCAs, work similarly to SNRIs in that they prevent the reuptake (or breaking down) of serotonin and norepinephrine.
They can also have an antihistamine effect, which can make them slightly sedative. They are an older-generation antidepressant and can be a good option for someone who hasn’t had luck trying newer medications.
Common TCAs include:
- Amitriptyline (Elavil)
- Nortriptyline (Aventyl, Pamelor)
Norepinephrine and dopamine reuptake inhibitors (NDRIs) also help to block the breakdown of norepinephrine, as well as the brain chemical, dopamine, which helps you to feel pleasure, motivation, and satisfaction. They’re also used to help people quit smoking.
The only NDRI antidepressant on the market is bupropion (Wellbutrin; see Important Safety Information).
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Monoamine oxidase inhibitors (MAOIs) were among the first antidepressants discovered. They work by blocking the enzyme that breaks down brain chemicals that contribute to a good and stable mood (like serotonin, epinephrine, and dopamine). They tend to have negative interactions with other drugs, so they aren’t usually a first-line treatment option for depression.
Common MAOIs are:
- Phenelzine (Nardil)
- Selegiline (Emsam)
How long does it take for antidepressants to work?
Antidepressants often take a few weeks to work. Some people start to feel better within a week or two, and others feel better after 6–12 weeks once the drug takes full effect. You might experience uncomfortable side effects like nausea or loss of sex drive, though these often decrease or go away with time (Rush, 2022).
Each person responds to depression medications differently, so it’s helpful to be patient and keep in touch with your care provider about how you’re feeling. You may need to try a few different doses or types of medications until you find the one that’s right for you, and that’s okay—there are many options to try.
Even if you feel like your antidepressants are ineffective, it’s important to remember that you should never stop taking your depression medication suddenly and without letting your care provider know. Most antidepressants need to be tapered off slowly, or you might experience serious side effects (Rush, 2022).
Can you get antidepressants over the counter?
Antidepressant medication is not available over the counter because antidepressants aren’t appropriate for everyone to take, need to be taken according to special regimens, and have a chance of interacting with some other medications. This means that they’re safest to take under the guidance of a healthcare professional.
However, there are several over-the-counter options that can help with depression.
Research on them is more limited than with conventional drugs, but evidence does indicate they help relieve depression symptoms in people with mild or moderate depression. One example is St. John’s Wort. A review of clinical trials found that St. John’s Wort supplements reduced mild, moderate, and severe depression symptoms (Setorki, 2020).
Note that you shouldn’t take this herb with other antidepressants. If you’re interested in trying an over-the-counter treatment, check in with your healthcare provider first. Herbs and supplements, while less regulated than medications, still have the potential to interact with other medications you take.
Psilocybin for depression: does it work?
Ways to get help for depression right away
Sometimes depression becomes acute and frightening. If you’re having thoughts of suicide or self-harm, it’s important to get help right away.
If you or someone you know is experiencing thoughts or behaviors of suicide or self-harm, help is available for free. Contact the National Suicide Prevention Hotline.
National Suicide Prevention Hotline: 1-800-273-8255
Or text TALK to 741741 to text with a trained crisis counselor
There are also large national and international organizations with 24/7 phone lines, free online and in-person support groups, educational resources, and other great tools to help you manage depression or mental health issues. Check out:
- Mental Health America (MHA)
- 7 Cups of Tea
- National Alliance on Mental Illness (NAMI)
- Anxiety and Depression Association of America (ADAA)
- National Institute of Mental Health (NIMH)
Treating depression can be a hard process, and it’s okay to feel discouraged sometimes. Medication can be a great tool to help get you on a path to feeling good again, so if you’re curious about it and are feeling depressed, talk to your healthcare provider to see if antidepressants are right for you.
- Bains, N. & Abdijadid, S. (2021). Major depressive disorder. StatPearls. Retrieved Mar. 13, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK559078/
- Chand, S. P. & Arif, H. (2021). Depression. StatPearls. Retrieved Mar. 13, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK430847/
- Huecker, M. R., Smiley, A., & Saadabadi, A. (2021). Bupropion. StatPearls. Retrieved Mar. 13, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK470212/
- Mann, S. K. & Marwaha, R. (2022). Posttraumatic stress disorder. StatPearls. Retrieved Mar. 13, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK559129/
- Munir, S. & Takov, V. (2022). Generalized anxiety disorder. StatPearls. Retrieved Mar. 13, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK441870/
- Rush, J. A. (2022). Patient education: Depression treatment options for adults (Beyond the Basics). UptoDate. Retrieved Mar. 13, 2022 from https://www.uptodate.com/contents/depression-treatment-options-for-adults-beyond-the-basics
- Setorki, M. (2020). Medicinal herbs with anti-depressant effects. Journal of Herbmed Pharmacology, 9(4), 309-317. doi:10.34172/jhp.2020.39. Retrieved from http://herbmedpharmacol.com/Article/jhp-6336
- Sheffler, Z. M. & Abdijadid, S. (2021). Antidepressants. StatPearls. Retrieved on Mar. 13, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK538182/
Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.