For many people, finding the right depression treatment takes trial and error. An antidepressant may work well for one person but not at all for someone else — and experts don’t yet have ways to predict this.

In other cases, a person may start to feel better on an antidepressant, but the side effects are too bothersome to keep taking it.

To improve your chances of finding the depression medication that works best for you, look for the following signs that your antidepressant isn’t working well enough or is no longer working the way it should.

11 Signs Your Antidepressants Aren’t Right for You

Here are 11 signs that the antidepressant you are taking may not be right for you.

1. You Feel Better Right Away, but It Doesn’t Last

Exactly how antidepressants work is still a mystery. The effects are thought to be related to changes in neurochemicals in your brain, such as serotonin, dopamine, and norepinephrine. These changes usually take 2 to 12 weeks to set in, with a peak at 6 to 8 weeks.

So if you feel different immediately after starting a depression treatment, it could be a placebo effect, says Joseph Hullett, MD, former medical director of behavioral health services at Molina Healthcare in San Juan Capistrano, California.

Sometimes that placebo effect wears off, and the actual effect of the antidepressant kicks in. Other times the placebo wears off, and the intended effects of the antidepressant are never felt. In this second case, it isn’t that the medication stopped working — it’s that the medication just didn’t work for you in the first place.

2. You Skipped a Dose or Several

This is a common situation. Busy people often miss doses or take their medication at irregular intervals. Not taking an antidepressant medication consistently can prevent it from working as well as it should. It may even prevent it from working at all, Dr. Hullett cautions. This can cause people to abandon what otherwise might be a very effective treatment.

Make sure you inform your physician that you have been missing doses before a decision is made to stop or change your antidepressant

3. You Can’t Sleep Well

“Antidepressants can make you feel more sleepy or less sleepy, and affect your libido and sex life, which can affect your sleep,” says Karen Lim, MD, a double board-certified psychiatrist at Prairie Health, a telepsychiatry platform based in California.

“Some people are also surprised to know that antidepressants can cause vivid dreams, myoclonus (sudden jerking of limbs especially at night and when tired), and rarely, seizures,” Dr. Lim adds. Having a good sleep schedule is important.

The following tweaks to your bedtime routine can be enough to correct some of these issues:

• Try relaxation techniques, such as deep breathing.
• Exercise during the day rather than at night.
• Listen to calming sounds and music, or watch calming videos.
• Talk to your doctor about taking an over-the-counter sleep aid like melatonin.

4. Your Mood Is Still Low After a Few Months

If that doesn’t seem to be happening, discuss this with the healthcare provider who prescribed it, as you might need to try a different antidepressant or have the dosage changed.

5. You Are More Energetic but Still Feel Blue

“If you feel more physical energy after starting an antidepressant, but you still have depression, that’s good and bad news,” says Gabriela Cora, MD, a psychiatrist in Miami. “It means the depression medication is starting to work but not in the right way.”

Increased physical energy combined with depression is a bad combination that can make you have increased irritability or impulsivity, or increase the risk of suicide, she explains. “So report these symptoms to your doctor right away,” Dr. Cora says.

6. You’re Experiencing Unpleasant Side Effects

7. You Show Symptoms of Serotonin Syndrome

Symptoms to watch out for, Lim says, include fever, aches, shakes, sweats, fatigue, irritability, a bad headache, confusion, agitation, restlessness, dizziness, difficulty seeing or walking, muscle twitching, muscle tension, or jaw clenching.

Typically, serotonin syndrome happens within days or weeks of starting an antidepressant or after a dose increase, says Lim.

8. Your Antidepressant Doesn’t Pack the Same Punch

“If you’ve been on an antidepressant for a long time, your body may develop a tolerance,” Hullett says. As a result, a medication that once worked well at quelling your sadness, anxiety, and other symptoms no longer has that power.

According to Hullet, sometimes increasing the dose under the supervision of your doctor may help. “If you’ve been taking 10 milligrams (mg) of Prozac (fluoxetine), for example, your physician may increase the dose to 20 mg,” he says. In other cases, trying a different medication or treatment is helpful. It is important to discuss increasing your dose with a doctor.

9. Your Depression Worsens

“If your depression symptoms get worse as soon as you start taking an antidepressant, or they get better and then very suddenly get worse, it’s a sign that the depression medication isn’t working properly, and you should see your healthcare professional right away,” Hullett says.

10. Your Mood Has Improved, but You’re Still Not Yourself

If you experience some relief on an antidepressant, but it’s not the relief you hoped for, talk to your doctor about other treatments. They may suggest a combination of treatments. Options may include trying another depression medication or the addition of counseling, psychotherapy, mood-boosting cardio exercise, or light therapy to your treatment regimen.

11. Your Mood or Energy Improve Too Much

“Depression medications can sometimes cause mood swings, especially in people who have a tendency toward bipolar disorder — depression and mania,” Hullett says. If you feel unusually elated or you become very terse with your spouse, feel noticeably more irritable, or have an uncharacteristic bout of road rage, you probably need to change your antidepressant, he advises.

The Takeaway

Discovering the correct antidepressant balance can be challenging since what works for one person might not work for another. It’s important to recognize signs that your medication might need adjusting, such as feeling persistently low or having intense side effects. Always communicate any concerns to your healthcare provider to consider exploring alternatives that meet your needs.