Dr. Alyssa Wood, DO, MBA, a double board certified doctor in adult psychiatry and child and adolescent psychiatry, says that if depression or anxiety is impacting your daily life, this is a good indicator that you should talk to your healthcare provider to see if a prescription medication could help. “Are symptoms interfering with your ability to get up in the morning, eat, shower, go to work, interact with others, concentrate or sleep? Any negative impact on one’s ability to care for themselves or complete daily tasks is a red flag,” Dr. Wood says. “More severe symptoms to watch out for include feelings of emptiness, pulling away from loved ones or activities that are usually enjoyable, or any thoughts of self-harm. Generally, the more severe the symptoms, the higher the likelihood a medication will be needed.” Dr. Douglas Misquitta, MD, a psychiatrist in the Department of Psychiatry and Behavioral Health at The Ohio State University Wexner Medical Center, adds that if someone’s symptoms are creating a safety concern, such as contemplation of suicide or feeling hopeless, this is another time to consider medication. “Medications can be helpful with less severe symptoms as well to improve quality of life. If someone is wondering about medication, telling their physician or psychiatrist what they are experiencing and asking about medication options would be a good way to start the conversation,” he says. Primary care physician Dr. Jeffrey S. Gold, MD, agrees that medication can help with anxiety and depression, but emphasizes that therapy and lifestyle factors—such as eating nutrient-rich foods, regularly moving your body, getting good quality sleep and using relaxation techniques—can also be hugely beneficial. If you do want to try a prescription medication, there are several important questions to make sure you have the answers to before you leave your doctor’s office with your Rx. Keep reading to find out what they are.
What Questions Should I Ask My Doctor Before Starting a Medication for Anxiety or Depression?
Here are the most important questions to ask, according to doctors:
1. What type of medication is best?
There are several different medication options for anxiety and depression and determining which one is the best fit for you is something that should be discussed with your healthcare provider. “If someone is considering medication for anxiety or depression for the very first time, often the discussion could include the first-line recommended medication class [the first treatment given],” says psychiatrist Dr. Suzanna Chen, MD, adding that even when considering this class of medications, there are factors to consider. “Those factors could include if there are any co-occurring psychiatric or general medical disorders, personal preference, cost, safety, tolerability, possible side effects if any of your family members have responded well to a certain medication, any prior experience with medications in the past, and the various properties of the medication including drug interactions and half-life,” she says. For this reason, it’s important to be completely open with your healthcare provider about your symptoms, medical history, family history and lifestyle so they can figure out what medication is the best fit.
2. What are the side effects?
“Keep in mind that all medications, not just antidepressants, can have side effects,” Dr. Wood says. She says that, for most people, these side effects are relatively mild. “Generally, SSRIs are used first-line in treating both depression and anxiety. The most common side effects that I see clinically include changes in appetite, nausea, headaches, dizziness, dry mouth, changes in sleep, and nervousness. Another frequently seen side effect that isn’t talked about as much as it should be is sexual dysfunction,” she says. Sometimes, Dr. Gold says, the side effects of certain medications may actually work in someone’s favor. For example, he says that some medications may cause drowsiness, which can be a benefit to someone who is having trouble sleeping due to anxiety or depression. It’s important to be aware of all the potential side effects and weigh the pros and cons when considering a new medication. Dr. Wood says that typically, side effects go away a week or two after starting a medication. If they don’t, it’s absolutely something you should tell your healthcare provider about.
3. How exactly should I take it?
Don’t assume that taking your new medication is as simple as knocking back a capsule with a glass of water. Dr. Chen says that some medications should be taken with food while others don’t have to be and some others should only be taken at night while for others, morning is best. “The consequences can be severe if medications are taken in a way they are not meant to,” adds Dr. Misquitta. “For example, taking less than prescribed could leave symptoms untreated or allow for worsening of symptoms, and taking medication at a higher dose than prescribed could lead to side effects, and these can potentially be very harmful or lethal.” He adds that if you are taking any other medications or supplements, it’s important to tell your doctor in case they would negatively interact.
4. Can I drink alcohol while taking my medication?
If you drink alcohol or use marijuana or other drugs, it’s important to ask your doctor how they could potentially interact with your medication. Dr. Gold says that since alcohol is a depressant, he generally advises people who are depressed to avoid it. “The cleaner the slate you have to work with, the better,” he says. Dr. Misquitta adds to this, saying, “It is best to avoid these substances when taking medications, as the combination could lead to unexpected side effects, decreased effectiveness of medications, or more pronounced effects than intended.” If you do drink alcohol or use marijuana (or any other drugs or supplements for that matter), Dr. Gold says it’s important to tell your healthcare provider so you can be aware of how they may or may not interact with your medication.
5. How soon will it work?
All four doctors say that how fast someone can expect to notice a difference depends on both the person and the medication. “Generally, antidepressants may take four to eight weeks in order to work. However, with some other medications and even some specific antidepressants you may notice a difference much earlier,” Dr. Chen says. If you have been taking your medication for eight weeks and don’t notice a difference, Dr. Gold says to bring it up to your healthcare provider. They may decide to change the dosage or prescribe a different medication.
6. What if I miss a dose?
Dr. Chen says that different medications work differently, so if you miss a dose, it’s important to contact your healthcare provider so they can give you specific instructions on what to do. But in general, if you miss the one-off dose, it’s not a big deal. “If you forget to take your medication and it’s almost time for your next dose, you can just skip the missed dose and take the next one as scheduled,” Dr. Wood says. “However, let’s say you are someone who takes your medication in the morning. If you forget to take it, but then remember later in the afternoon or evening, then go ahead and take it as soon as you remember. You just want to make sure you’re not doubling up on your dose that day. That’s not necessary and can lead to unwanted side effects.”
7. Will I be on this medication forever?
When starting a new medication, it’s natural to wonder how long you’ll need to take it. Dr. Gold says that part of knowing the answer to this is pinpointing the root cause of someone’s anxiety or depression. If it’s situational—such as tied to the loss of a loved one, divorce or experiencing a particularly stressful time—it’s likely that the person will not be on the medication forever. However, he says there are some people who function much better while on medication and would not consider going off it. “Typically, I tell people to give it six months, and then we can reevaluate,” he says. While medication isn’t and shouldn’t be the only way to treat anxiety or depression, for many people it can certainly help. Bring this list of questions with you to your appointment to ensure you leave with all the facts. Your health depends on it! Next up, see five things you should never do if you struggle with anxiety—and what to do instead.
Sources
Dr. Alyssa Wood, DO, MBA, double board certified doctor in adult psychiatry and child and adolescent psychiatryDr. Douglas Misquitta, MD, psychiatrist in the Department of Psychiatry and Behavioral Health at The Ohio State University Wexner Medical CenterDr. Jeffrey S. Gold, MD, family medicine doctorDr. Suzanna Chen, MD, psychiatrist
