What I wish patients knew before starting an antidepressant
By Dr. Yujal Man Singh, MD (Psychiatry) · Medically reviewed · 20 September 2026
Almost every week someone sits in front of me holding a new prescription and a worried face. Will this change my personality? Will I get addicted? Will I have to take it forever? Here is what I tell them, in the same plain words.
1. It will not work on day one
Most antidepressants take two to four weeks before you notice a change, and six to eight weeks for the full effect. Sleep and appetite often improve first. Mood comes later. If you stop after five days because “nothing happened”, you have not really tried it.
2. Side effects usually come early and settle
Mild nausea, headache, feeling restless or sleepy are common in the first one to two weeks. For most people they fade. Tell me if they do not, because we can change the dose, the timing, or the medicine.
3. They do work, and there is choice
A large network meta-analysis in The Lancet, covering 522 trials and more than 116,000 people, found that all 21 antidepressants studied worked better than placebo for adults with depression. They differ in side effects, which is why the choice is made with you, not for you [1].
4. Antidepressants are not addictive
You will not crave them or need more and more for the same effect. But stopping suddenly can cause dizziness, irritability or “electric” feelings for a few days. That is why we reduce slowly.
5. Feeling better is not the moment to stop
This is the most common mistake I see. A systematic review in The Lancet found that continuing an antidepressant after getting better cut the risk of relapse by about two thirds compared with stopping (18% versus 41% relapsed) [2]. For a first episode, I usually advise continuing for six to twelve months after you feel well, then stopping slowly together.
6. Medicine is one part of the plan
For many people, therapy such as TEAM-CBT, sleep, movement and support from family matter as much as the tablet. Some people need only therapy. We decide together.
7. Ask me anything
No question is silly. Write your questions down before the appointment. If you live abroad, I can also write to your local doctor about your medicine.
Research behind this article
- Cipriani A, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet 2018;391(10128):1357-1366. doi:10.1016/S0140-6736(17)32802-7
- Geddes JR, et al. Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. Lancet 2003;361(9358):653-661. doi:10.1016/S0140-6736(03)12599-8
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