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Do Antidepressants Work Immediately?

Do antidepressants take 6 to 8 weeks to kick in? In the case of many people, yes. However, for other people that notice a major effect immediately upon taking the medication, it may come as a surprise that the drug is already working when their doctor or psychiatrist told them it would take awhile. Although the drug may not reach its full potential until a month or so into the treatment phase, many people notice that antidepressants affect them within the first few days of treatment.

Keep in mind that everyone’s experience on these drugs is different. Just because one person notices the drug in their body on the first day, does not mean they are having a placebo effect – many doctors do not realize how quickly these medications work for some.  If your antidepressant doesn’t work right away, read more about why antidepressants take so long to work.

My personal experience with Paxil CR: Kicked in the first day

When I first started my treatment on Paxil CR 12.5 mg, I noticed the drug kicked in the very first day I took it. I originally had more energy and felt some excitement on Day 1. I noticed a huge boost in mood and energy by day 3. At the time I was age 15 and didn’t really know much about these SSRI drugs or how they worked. I just assumed that if I threw it down the hatch I would become happy and less anxious. By the end of the first week I had transformed from an anxious introvert to a full blown extrovert – this was totally unexpected.

SSRI’s may work way quicker than what your doctor tells you

The odd thing is that my doctor had told me it would take 4 to 6 weeks for this drug to have any kind of an effect. Although there is the possibility of a placebo effect, I didn’t expect to feel anything for awhile. I felt way too good for this to be a placebo and noticed other side effects like increased sweating by the end of the first week. To make a long story short, this drug stopped working after 6 months. The drug did work on the very first day in my case – so don’t assume that just because you are starting an antidepressant it is going to take the full 6 weeks.

Although I don’t have any exact research to support my hypotheses of why antidepressants work quicker in certain people, I do have some ideas that I figured I’d share.  In addition to the ideas below, it should be mentioned that researchers recently discovered that an SSRI changes brain connectivity within hours, rather than weeks like most “professionals” originally suspected.  This further supports the idea that you are not crazy or abnormal if your drug has an immediate effect.

Antidepressants may work immediately if you fit the following:

1. Physically Fit – If you have a high metabolism and work out frequently, you are going to feel the effects quicker than someone who doesn’t. This is because your body is working to digest and grind up everything that enters it in a quick and efficient way. You don’t have a bunch of waste sitting inside your gut rotting. Therefore when the drug is introduced, it will have a clear channel to work quicker.

2. Higher dose – The higher the dosage of the drug, the quicker you will feel the effects. You may feel a bunch of side effects right away before the antidepressant effect though. In my opinion, it is better to start at a low dose and titrate upwards to a therapeutic level. What may be therapeutic for you may be lower than what is for someone else.

3. Internal Awareness – Are you aware of your body and any internal comfort or discomfort. If you have an internal focus and are aware or hyperaware of your body’s functioning, you will probably notice the medication kicking in before most people.  If you have poor internal awareness or recognition of physical symptoms throughout your body, you may not even feel the effects of the drug until it has built up in your system.

4. Hypersensitivity – Certain people are hypersensitive to medications and/or things in general. For example people with high stress or PTSD may be hypersensitive to sounds and bright lights. If you are hypersensitive, it usually stems from being hyperaware of bodily functions. Initially the side effects of the medication may be greatly amplified in your head due to this sensitivity.

5. Eat healthy – If you eat healthy foods, chances are there won’t be a build up of preservatives or junk in your body. A lot of unhealthy foods have additives that can have somewhat of an influence over mental functioning. If you are eating good foods that can be efficiently digested by your body, any foreign substance like a chemical (i.e. medication) will be more noticeable than if your system is already flooded with crap.

6. Drug free – People that do not use any other drugs like marijuana, cigarettes, or other prescriptions will probably notice the effects of an antidepressant sooner because they aren’t flooded with chemicals from other sources.  If you take an array of drugs (illicit or not) on a consistent basis, it may be more difficult for you to notice the effects of the antidepressant that you’re taking.

7. Alcohol free – If you aren’t drinking alcohol and there is no outside influence on your nervous system from drinking, the drugs will likely work quicker. Think of being fully detoxified vs. drinking off and on for the past year. The person who stayed clean is going to notice the effects quicker.  Alcohol has an impact on your nervous system and the effects can

8. Caffeine free – Caffeine is a stimulant that can influence mental activity as well as our CNS functioning. It is a fairly addicting substance and people can become dependent upon caffeine in their everyday functioning. The fact that it is in your system may cloud your ability to notice what the antidepressants are doing – especially if you are a heavy caffeine drinker.  It is a stimulant and can have a significant affect on the nervous system.

9. Never used an SSRI – Someone who has never used an SSRI in the past will likely notice the effects quicker than someone who hasn’t.  This goes for other related-medications as well.  If you have used an SSRI or SNRI or some form of an antidepressant in the past, you will probably notice the drug in your system much more quickly than someone who hasn’t.  This is due to the fact that a foreign substance (i.e. chemical) is entering your body.  Your body (and brain) change from a homeostatic state to being under the influence of the drug.

10. Strong reaction (positive or negative) – Depending on your preexisting brain chemistry and nervous system activity, certain medications may induce a strong reaction. You may notice a strong positive reaction or negative reaction within the first few days of taking it. None of these drugs are natural, so altering certain neurotransmitters may feel pretty powerful.

If your antidepressant works immediately

If your antidepressant works right away within the first couple days that you take it, you may be on a fast-acting medication like Paxil or Effexor.  These medications tend to work quickly, but end up reaching a plateau within a few months.  Following this plateau you may experience a gradual “poop out.”  In other words, the medication will eventually stop working.  Anyways, it is important to realize that general practitioners and standard medical doctors are fairly uneducated when it comes to mental health medications.  Most just follow the literature instead of following people’s actual experiences.  This is unfortunate because when a drug kicks in right away, the patient may not know what to expect.

It is more realistic for doctors and psychiatrists to say that a medication should reach it’s peak effectiveness within 4 to 8 weeks – not that it takes that long to work.  I’m sure some doctors and psychiatrists are up to date on these medications and how their patients have been affected.  Just keep in mind that if your medication works right away, it’s not “all in your head” and you may not be experiencing any type of “placebo” – that just shows you how powerful antidepressants can be.

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13 thoughts on “Do Antidepressants Work Immediately?”

  1. I’ll say that physicians and psychiatrists do know plenty of pharmacology. It’s not unheard of for patients to respond very quickly, but it’s very rare. For the vast, vast majority of patients (including my mother) antidepressants do take ~1 month to begin working, and several months to reach optimal effects. I think it’s beneficial for everyone to remember that the data scientists use is the experience of tens of thousands of patients over the span of several decades.

  2. Probably the best entry, and I’ve read many on this blog (it is a good blog). Paradoxical effects of acute SSRI is a mystery worth solving. For me a complete cure at least for a day, I get done at least 10x as much in this span and feel social and normal.

    It has happened to me at least 3 times when initiating SSRIs. The remainder of SSRI “therapy” simply sucks rotten eggs for me, complete zombification. 5-ht1a-b, 5-ht6, 5-ht2, amygdala GABA, DA, 5-ht ablation, mania, who knows? But I would like to know why.

    • The answer to the acute SSRI effect most likely lies in the 5-HT1A receptor(s). Although some of those other receptors you listed could also be involved.

      Unfortunately, the article is in Hungarian. The entire PDF can be found via search.

      Antidepresszívumok, stresszorok és a szerotonin 1A receptor.
      Kirilly Eszter, Gonda Xénia, Bagdy György
      Abstract: 5-HT1A receptor is a receptor of surprises. Buspirone, an anxiolytic drug with a then yet unidentified mechanism of action had been marketed for years when it was discovered that it is a 5-HT1A partial agonist. Several more years had to pass before it was accepted that this receptor plays the key role in the action mechanism of buspirone. This was followed by further surprises. It was discovered that in spite of its anxiolytic effect buspirone activates the hypothalamic-pituitary-adrenal (HPA) stress axis, furthermore, it increases peripheral noradrenaline and adrenaline concentration via a central mechanism. Thus activation of this receptor leads to ACTH/corticosterone and catecholamine release and also increases beta-endorphine, oxytocin and prolactin secretion while decreasing body temperature, increasing food uptake, eliciting characteristic behavioural responses in rodents and also playing a role in the development of certain types of epilepsy. Human genetic studies revealed the role of 5-HT1A receptors in cognitive processes playing a role in the development of depression such as impulsiveness or response to environmental stress. This exceptionally wide spectrum of effects is attributable to the presence of 5-HT1A receptors in serotonergic as well as other, for example glutamatergic, cholinergic, dopaminergic and noradrenergic neurons. The majority of the effects of 5-HT1A receptors is manifested via the mediation of Gi proteins through the hyperpolarisation or inhibition of the neuron carrying the receptor. 5-HT1A receptors on serotonergic neurons can be found in the somatodendritic area and play a significant role in delaying the effects of antidepressants which is an obvious disadvantage. Therefore the newest serotonergic antidepressants including vilazodone and vortioxetine have been designed to possess 5-HT1A receptor partial agonist properties. In the present paper we focus primarily on the role of 5-HT1A receptors in stress and antidepressant response.

  3. This was my experience. When the SSRI worked, it worked immediately (within hours and days) and when it stopped working, the same applied. Don’t let your doctor tell you to F off and give it time to work (the usual see me in 5 weeks) when your body is screaming at you that the drug has stopped working and you need something else. Basic pharmacology is way beyond some of these guys. I only started getting half decent treatment when I stopped just nodding at the ‘expert’ and starting being much more forceful.

  4. I had a relief from anxiety within hours of taking 10mg lexapro… I had Been drug free for past 6 months after 10 years in lexapro. However decided that it has not been worth the daily struggle to fight off anxiety and negativity. Not sure if a placebo or not but The main thing is I feel no anxiety and its day 1. It’s almost as though my body knife exactly what to do with it and was relieved… The only thing now is if that’s true will you’ll never be able to get off them?

  5. Lexapro started working for me (I have intrusive thoughts) after 2,5 weeks. Before I was on Luvox (fluvoxamine) for almost two years. I tapered that drug and relapsed a few months later. I started with Luvox again, but after 9 weeks nothing changed really, still had a lot of anxiety and obsessive thinking. Went to my GP again and he prescribed escitalopram.

    Worked great for like 5,6 years and then poop-out suddenly (at only 5 mg’s). Now I’m not sure if I want to take AD-medication again. Afraid they won’t work for me and afraid of side effects. Venlafaxine does interest me, but I wouldn’t take Paxil because of all the negative stuff I’ve read about it.

  6. I felt lexapro after a few hours… euphoria, anxiety free feeling that lasted ever since. Zoloft worked amazing after 2 days, but stopped after 5 days totally.

  7. I felt the effects of my meds (Citalopram) within a few hours, which really threw me off since Prozac was like a sugar pill to me. Day three now and I can definitely feel it.

  8. Hi, just wanted to let you know that the points you mention don’t fit me at all and Escitalopram worked for me right away, too.

    I am overweight, don’t exercise that often, drink coffee and smoke weed. I was started on Lexapro 10mg and by the 3rd day I was waking up happy, fresh and full of life (which I had rarely felt before in my whole existence). Past the first week I had mild euphoria like symptoms which were assumed to the fact that maybe my mind was playing a trick on me.

    After 6 months the Lexapro stopped working, so I had the dose increased to 20mg. The increase made me feel that mild euphoria I felt the first time, but this time it was more physical, like my chest was being pumped up. I had never felt that before Lexapro.

    3 days after that, I crashed pretty hard into a severe depression for almost 4 weeks. It turned out the Lexapro worked wonders really fast because it sent me into hypomania, revealing a brand new diagnosis of bipolar disorder ii.

    Thought that sharing that with you would contribute to your theory. Best of lucks. Wish you well. :)

    • Appreciate you sharing your experience about Lexapro working right away. So many people report that these antidepressants take “weeks” to work that if it does work right away, people are surprised because their doctor said it would take awhile. Although for many individuals it does take weeks for the medication effects to kick in, not everyone fits this mold.

      It should also be noted that just because a medication-induces hypomania does not necessarily mean that a person has any type of Bipolar disorder. If no hypomanic symptoms ever occurred prior to taking the medication, I would be skeptical about the legitimacy of a BP2 diagnosis.

      Hope all is well, thanks again for sharing.

    • Hey, I have been going through an almost identical experience to the one you have described here for a little over a year now, but with mirtazapine initially, then zoloft and finally citalopram. I have felt really good and completely free of all depression related symptoms the first two weeks of taking all three of those mentioned and then felt absolutely no benefit after.

      This has also applied to increasing my doses; I feel great initially then again after about 2 weeks i slump back into depression. I’m at a bit of a loss as to what to do now and was 1) concerned I may be experience bipolar type 2 or something else. 2) considering going back to see a psychiatrist and not my gp. Not sure if either of you will see this but if you do and have any thoughts, suggestions, that would be great :) -Harry

      • Hi, from my experience taking lexapro, which did exactly what you described… felt good at first but soon crashed. Upping the dosage only worked for a couple days. How I understand it is – your brain becomes rewired and can take quite awhile to go back to homeostasis. Completely changing the type of antidepressant might be more beneficial or a combo of two. I would go to the psychiatrist. They are specially trained in this field and will know best. (Not a regular counselor or GP)… best of luck to you!!

    • The exact same thing happened to me. Every time I would increase my dosage (per my doctor’s orders), I was “high” for about a week. Then I would fall, and it was worse than before. Lather, rinse, repeat.

      Finally, my therapist told me that she wanted me to see a psychiatrist because she was seeing signs of bipolar. My father was bipolar 1. Apparently, this is common for Bipolar 2 and antidepressant use. They put me on Lamictal (on 200mg daily), and what a difference!


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