Should You Change Your Depression Treatment? How to Tell
Mental Health ConditionsDepression

5 Signs You Should Change Your Depression Treatment

5 Signs You Should Change Your Depression Treatment
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Published on June 10, 2026
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Antidepressants can improve symptoms of major depressive disorder (aka depression), but not all options work well for everyone.

 “Depression is biologically complex, and people differ in brain chemistry, genetics, metabolism, [co-occurring] medical conditions, stress exposure, and symptom patterns,” says Simon Faynboym, MD, a psychiatrist in private practice in Beverly Hills, California.
These drugs can also take time to work, says Bhawani Ballamudi, MD, a child and adolescent psychiatrist and the regional medical director of behavioral health for SSM Health in Wisconsin.

 “It may take up to six weeks when you first start an antidepressant to see the benefit, and two to three weeks when making dosage changes,” says Dr. Ballamudi.
Although you should take all medications as prescribed by your provider, you can talk to them if you feel your antidepressant isn’t working for you. If needed, they can help you switch to a new medication safely.

 Here are five signs that could mean you need a switch.

1. Your Mood Isn’t Getting Better

Your provider may consider switching your antidepressant if your mood hasn’t improved, even after giving it weeks to work. They may also suggest adding a second antidepressant alongside the first, says Ballamudi.

“Someone should speak with their doctor if depressive symptoms are not improving after several weeks,” says Dr. Faynboym. He also recommends reaching out to your doctor if symptoms like sadness, low motivation, hopelessness, anxiety, insomnia, or difficulty functioning continue to interfere with your daily life.

2. You Have Too Many Side Effects

Antidepressants can cause side effects like dry mouth, nausea, headaches, weight gain, sexual dysfunction, and trouble sleeping.

 These uncomfortable symptoms often improve over time, but sometimes they stick around.

“I consider switching when side effects are persistent, distressing, or begin to outweigh the antidepressant’s benefits,” says Faynboym. For example, severe nausea or sexual dysfunction can interfere with work, relationships, and quality of life, says Faynboym. If you have severe side effects that don’t get better, tell your provider.

3. You Still Feel Fatigued

You may feel fatigued from both depression and your antidepressants, but this symptom should fade after you’ve been on the medication for a few weeks.

 If it doesn’t, you can ask your provider about another option, says Ballamudi.

“Persistent fatigue can sometimes be caused or worsened by certain antidepressants, particularly those with more sedating effects,” says Faynboym. For his patients, he considers dose changes or other medications if fatigue stays strong.

4. You’re Not Sleeping Well

Depression can make it hard to get good sleep, but some antidepressants can also cause sleep problems, especially at first.

One large research review that included 166 studies in its insomnia analysis found that the following drugs are more likely to cause sleep disturbances than others:

  • vilazodone (Viibryd)
  • desvenlafaxine (Pristiq)
  • venlafaxine (Effexor XR)
  • sertraline (Zoloft)
  • citalopram (Celexa)
  • fluoxetine (Prozac)
  • paroxetine (Paxil, Paxil CR, Pexeva)
  • escitalopram (Lexapro)

If your sleep doesn’t get better, even after giving your body time to adjust to your antidepressant, let your provider know.

5. You Notice New Depression Symptoms

Sometimes antidepressants improve symptoms for a while, but then they come back.

 “Reemerging symptoms can occur because of stress, changes in sleep or health, medication tolerance, interactions with other substances, or progression of the underlying illness, and early intervention often prevents symptoms from becoming more severe,” says Faynboym.

Tell your provider about any new stressors, changes in your life, or new medications, supplements, or drugs you’re taking, which can potentially change the medication levels and effectiveness and contribute to worsening depressive symptoms, says Ballamudi.

How Switching Antidepressants Works

Switching antidepressants usually requires a precise dosing schedule.

 “Antidepressants should generally be switched gradually and under medical supervision to reduce the risk of withdrawal symptoms, medication interactions, or relapse of depression,” says Faynboym.
Some common antidepressant switching techniques include:

  • Cross-taper: Slowly lowering your first antidepressant dose while increasing the dose of your new medication at the same time (usually over two to four weeks).
  • Direct switch: Stopping your first antidepressant and taking the new drug the next day.
  • Taper, stop, and switch: Lowering your antidepressant dose until you can stop taking it, then starting the next drug the following day.
  • Taper, washout, and switch: Lowering your dose, taking no antidepressant for a “washout” period, then starting the new drug.
  • Stop, washout, and switch: Stopping your antidepressant (without tapering), waiting for a period, then starting the new medication.

Your psychiatrist will recommend one of these strategies depending on the medications involved, says Faynboym.

Don’t stop taking your antidepressant on your own — talk to your provider first. If you stop some antidepressants suddenly, you may experience antidepressant discontinuation syndrome (aka antidepressant withdrawal), which can have symptoms like worsened depression, anxiety, dizziness, electric shock sensations, and trouble sleeping.

“Finding the right antidepressant is often a personalized process,” says Faynboym, who says his patients sometimes get discouraged when they need to switch. “But with careful monitoring, open communication, and a willingness to adjust the treatment plan, many people ultimately find an approach that significantly improves their mood and functioning.”

The Takeaway

  • Antidepressants can take weeks to improve your symptoms, but if you don’t feel better after an adjustment period, you can ask your provider about a treatment change.
  • Your provider may recommend switching your antidepressant if you have severe side effects, you’re not sleeping well, or you notice depression symptoms returning.
  • Always talk to your provider before you stop taking an antidepressant — they can help you decide on a treatment plan so you can switch safely.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
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  2. Mental Health Conditions: Depression and Anxiety. Centers for Disease Control and Prevention. October 13, 2023.
  3. How to Get Off Antidepressants the Safe Way. Cleveland Clinic. July 12, 2021.
  4. Antidepressants: Selecting One That’s Right for You. Mayo Clinic. September 23, 2022.
  5. Antidepressants. Cleveland Clinic. August 29, 2025.
  6. Antidepressants: Get Tips to Cope With Side Effects. Mayo Clinic. September 12, 2019.
  7. Yasugaki S et al. Bidirectional Relationship Between Sleep and Depression. Neuroscience Research. February 2025.
  8. Antidepressants: Starting to Take Antidepressants for the First Time. University of Oxford.
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  12. Depression in Adults: Treatment and Management. National Institute for Health and Care Excellence. June 29, 2022.
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Angela D. Harper, MD, is in private practice at Columbia Psychiatric Associates in South Carolina, where she provides evaluations, medication management, and psychotherapy for adul...

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