If I prescribe an antidepressant, patients always ask, “How soon will it work?”
The standard answer, one that’s been in the literature for years, is “two weeks,” with the caveat that full effects may take weeks longer.
But clinicians have always suspected that some changes come about earlier. A (reasonably unreliable) rule of thumb is that a good, even if transient, initial response predicts a solid outcome later. And there have always been studies showing some improvement within days, so that patients are “better but not well.”
Now out of England comes research that should enter Guinness World Records.
Dr. Philip Cowen, a serotonin expert and head of the Psychopharmacology Research Unit of the Department of Psychiatry at Oxford, reports changes shortly after administering a single pill. When he gave an antidepressant to depressed patients, after four hours they were better able to pick out happy faces from a collection of images and to recall positive words from a list. Patients given a placebo showed no such change. The press release, from the Royal College of Psychiatrists, is titled "Antidepressants ‘can change the way depressed people see the world in just four hours.'" It's worth reading — won’t take you a minute.
Addendum: For a subsequent, related posting on early responses to antidepressants, see my note on treatments for premenstrual irritability.
I believe it
I was on an SSRI for years and although I intially was very unoptimistic about a drug's ability to help me, I experienced a dramatic reprieve from anxiety after only a few days on Paxil. I understand that the effects may be different for depression as oppossed to anxiety, but given thier common link, it seems like the rapid effets of drugs on depression may also apply to anxiety. I believe this to be true as I have come to use anti-anxiety meds only when I need them. I am not talking about something like xanax, but an SSRI ( currently zoloft). I came to a point where I felt I did not need to take something everyday and after having a hell of a time getting off paxil I was hesitant to start another daily regimen to cope with my intermittent boughts of anxiety. My doctor prescribed zoloft, assuring me it would be easier to quit than paxil but that for it to be effective I would need to take it everyday. I I often found myself forgetting to take the zoloft for days but upon remembering, feeling calmer immediately after taking a pill. The side effects weren't there when I was not taking the pill and so now I just take one when I have a presentation coming up or another anxiety provoking situation I feel unable to handle on my own. The effects are certainly there just after a day and it's nice to not have to constantly be on medication.