How long does Zoloft, Paxil, Lexapro or similar depression drugs take to kick in?

September 21, 2007 11:23 AM

How long does Zoloft, Paxil, Lexapro or similar anti-depressants drug take to kick in?

After several months of denying it, I'm pretty damn well clinically depressed. I plan on seeking abundant medical help, thanks very much. I'd like to try a selective serotonin reuptake inhibitor. How long does it typically take for one to feel the effects of a typical course of medication?

posted by anonymous to health & fitness (27 comments total)

There's no set answer, as far as I know. Plan on maybe a couple weeks. There's also the matter of determining the correct dosage, so you'll probably be started out low, then if that doesn't work you'll be slowly ramped up.

...upshot being, it might take a while.
posted by aramaic at 11:29 AM on September 21, 2007

1. The Placebo Effect may give you some improvement almost immediately.

2. Assume 30 days on a stable dosage before you really know how a given medicine is going to affect you. May start feeling effects sooner, but they may change as you increase and modify dosage. After about a month, you should know how you feel.

I am not a doctor. I speak from personal experience/research in the issue.
posted by bunnycup at 11:33 AM on September 21, 2007

My experience was roughly 2-3 weeks.
posted by zennoshinjou at 11:39 AM on September 21, 2007

My understanding is that you need to give the SSRIs (i.e. Paxil and Zoloft) a good six weeks before drawing any conclusions.
posted by foxy_hedgehog at 11:41 AM on September 21, 2007

SSRI's usually take 6-8 weeks before you notice any effects. Sometimes longer, sometimes shorter. You will almost always feel the "side effects" before the intended effects, unfortunately. Most people who go off meds early on do it because they haven't been willing to wait for the results.

Crazy Meds is an awesome site that can give you more insight on a specific medication.

disclaimer - IANAD, IANAP(harmacist), but IAOAD (I am on antidepressants)
posted by catfood at 11:46 AM on September 21, 2007 [1 favorite]

Zoloft is water-based (I'm sure I have the term wrong, someone please correct this) so it takes 24 hours to take effect and 24 hours to get out of your system.

Paxil is fat-based so it takes about a week to take effect and about a week to get out of your system.

I'd bet your doc will ask for a follow-up visit a week or two after you start your treatment. And ditto on what aramaic said--your doc will probably start the dosage low and gradually increase it to see how you're doing. It may seem like nothing's working at first but stick with it and let your doc know everything.

Best wishes on your honesty about what ails ya and seeking teatment. Don't rule out a visit to a psychologist either. No shame in either. If your stomach's aching, you take medicine for that. Brain's just another organ and not that different.
posted by Tacodog at 11:58 AM on September 21, 2007

Seconding catfood re: side effects. Make sure you have plenty of support from your doctor and/or therapist for the first couple of weeks, because you may feel worse before you feel better.
posted by moonlet at 11:59 AM on September 21, 2007

i felt some relief within a week and it seems like i reached the full effects within another week or two.

obviously, individual experiences vary greatly, and sometimes you have to try a few before you find something that works.

i encourage you to also seek therapy, which has been shown to be as effective as drugs (and in addition to drugs), and will certainly help you get through the acclimation period.
posted by thinkingwoman at 12:01 PM on September 21, 2007

My experience is 1-2 days. Seriously. I know people will say its placebo effect, but whatever. The side effects kicked in immediately also, so watch out.

Not that you asked, but I'll tell you. I wish I had never taken SSRI's, they're a slippery slope. I wish I had just tried therapy first.
posted by eightball at 12:28 PM on September 21, 2007

We have gone through this with my husband. It is a cycle.

He gets depressed, we argue about him getting some help. Eventually he goes in to the doctor who gets him to try Prozac, and then he goes back to the therapist.

It takes a few weeks for the meds to kick in for him. It isn't an easy process to go through, and I think he totally hates the idea although he is much happier. The talk therapy is a huge part of this, so don't just try to tough it out with just the medication. Go back for check-up to see how you are doing and change the medication if it isn't what you need.
posted by chocolatetiara at 12:42 PM on September 21, 2007

Two weeks is about average. For those two weeks, a lot of people report feeling "spacey"...it's a difficult feeling to describe, but its noticeable. It's also temporary.
posted by radioamy at 12:43 PM on September 21, 2007

Side Effects: a few days
Intended Effects: 2-3 weeks to feel a difference
Withdrawal Effects: begin ~1 day after missing a dose

IANAD, YMMV
posted by jsonic at 12:45 PM on September 21, 2007

It depends on the individual. My experience is also 1-3 days for some improvement with Lexapro and Wellbutrin, but I respond quickly to medication in general. Unlike eightball, I've found SSRIs incredibly helpful if used with awareness. Make sure you have a doctor who is responsive and caring (i.e. returns your calls and follows up on your progress). Good for you for seeking help, and good luck.
posted by walla at 12:48 PM on September 21, 2007

I should add that Wellbutrin is not an SSRI but works through a different mechanism. It is also supposed to work much more quickly than SSRIs. But it is not indicated for everyone, obviously. (IANAD and IANYD).
posted by walla at 12:53 PM on September 21, 2007

In my experience, Zoloft/Prozac (the SSRI drugs) took 2-3 weeks for them to take effect, and I felt Wellbutrin (the other class) within 24 hours.

Sounds like you are headed in a good direction, and good luck!
posted by lastyearsfad at 12:54 PM on September 21, 2007

IANAD, Tacodog, but I've been told that Zoloft (sertraline) has an unusually long biological halflife, not a short one. OTOH, googling for sertraline pharmacokinetics supports your statement, so now I'm confused. (Or maybe a 26-hour halflife is a long one?)

For the OP: my understanding matches other posters here, that the rule of thumb is that you should allow two weeks for the drug to really take effect, and six weeks to reach a steady state. You might feel effects faster than that, within a few days (and the side effects of some drugs may come on faster than therapeutic effects, unfortunately). And it varies a bit by drug and by individual.

Going a bit beyond the original question: it's common to have to try several antidepressants before you find one that works for you and doesn't have some side-effect. This appears to be mostly done by random chance and the doctor's intuition. This can be be extra sucky because although the common antidepressants aren't considered addictive, they do have withdrawal effects, some more unpleasant than others, which you'll encounter as you're tapering off one thing to try another. Crazymeds (linked above) has useful anecdotal info on that. Doctors sometimes don't seem to consider it important enough to mention.
posted by hattifattener at 12:57 PM on September 21, 2007

I started with Paxil and had six weeks of various side effects (the weirdest one being a feeling that my teeth were vibrating) before it suddenly *clicked* and I felt my depression leaving me. From what I understand, the reason it takes so long is that the SSRI fixes the serotonin, and the serotonin fixes something else, which fixes something else, and eventually your mood improves. Since doctors don't yet know what all those 'something else's are, they can't fix them directly, nor can they tell you how long it will take. Maybe the 1-3 day people only have one or two steps in the pathway broken, whereas the 6 week people have quite a bit of the pathway broken. (IANAD and I could be wrong about all of the above. Except the part about me and Paxil. I'm pretty sure I'm right about it taking me six weeks.)
posted by happyturtle at 1:07 PM on September 21, 2007

it took about four weeks for me to feel paxil was helping
posted by anadem at 1:28 PM on September 21, 2007

The newer ones - Lexapro, Celexa, etc - are faster than the older ones - Prozac, Paxil, Wellbutrin, etc. I only have experience with Lexapro but I've found that it kicks in in about a week to 10 days, sometimes even faster. I've heard from friends that the older SSRIs can take up to 4 weeks to do anything.
posted by mygothlaundry at 1:33 PM on September 21, 2007

They do vary. n my experience, Prozac had some effect in 24 hours, and side effects I couldn't tolerate. Zoloft took longer, and I tolerate it pretty well. Your emotions may be quite volatile at 1st, so make sure you get any help needed. Good luck.
posted by theora55 at 4:27 PM on September 21, 2007

It may take a while, depending. I've been on Prozac, Paxil, Wellbutrin, and now, Lexapro. All for seasonal depression. The first winter, Prozac worked just fine. The second winter, it didn't work, so we tried Paxil. That one made me strangely nihlistic, so the following winter we tried Wellbutrin. Despite the claims that side effects would show up within a week, it took a month before the horrifyingly itchy welts showed up. It was a shame, too, because the Wellbutrin didn't have the "sexual side effects" that Paxil and Prozac had. I was on Lexapro for the rest of last winter, and am starting it again in anticipation of this winter, and I feel great (no sexual side effects either- dogdad is rather grateful for that). What I'm trying to say is, don't give up if one doesn't work- even though they're all SSRIs, one will work for you better than the others. It just might take a bit to find the right one.
posted by dogmom at 5:19 PM on September 21, 2007

One thing I've noticed while dosage was being adjusted, and I should point out not on myself but a loved one—things can get worse before they get better. Things really sucked until the proper dosage was found. But in the end, it was worth it.

Many of the stories and studies on teen suicides related to antidepressants mentioned dosage adjustment, but I've yet to see it pointed to in anything other than anecdotal evidence, but my experience is that the period of adjustment can be as difficult if not more challenging than the depression itself.

Good luck, and please be patient.
posted by Toekneesan at 8:17 PM on September 21, 2007

I'm on Wellbutrin now and it's working wonderfully, but the first time I took it, my GP prescribed it and I went through two weeks of insomnia and heart-pounding, non-stop anxiety that could have been prevented if she'd known to 1)start low and ramp up my dose slowly and 2)break it into 2 or 3 times per day to start out. Before I settled back on the Wellbutrin, I went on and off 9(!) different anti-depressants that had such lovely side effects as constant teeth clenching, constant lethargy, constant hunger, and, my favorite - just plain not working. So it's important to educate yourself before you start on what to expect from your drugs both when you take them AND!!!! if you go off them AND go to a qualified psychiatrist - not your GP (YMMV if you trust your GP to do right by you).

Here's a few articles that helped me become a better mental health consumer:
What to Do (On and Off the Web) While You're Waiting for Your Antidepressants to Kick In
Demystifying Depression - Part I

I second the mention of Crazymeds also - some of the info is a bit old though but most of what I've read there has tracked very closely with my experience and by now - I've tried them all.

Good luck - it's a journey but you can come out on the other side. Just remember to keep going.
posted by katyjack at 7:08 AM on September 22, 2007

OH! I'm posting twice to add - if you've got an SO, it's worthwhile to take them with you to all the early appts and to make sure they are as educated as you are on possible side effects and adjustment problems. Sometimes it takes an outside party to be able to tell what's going on with you and it will be helpful to them to be able to say "It's just the meds. It's just the meds." when you burst into tears because you can't find the remote.
posted by katyjack at 7:11 AM on September 22, 2007

My experience:

Zoloft: gave me a strange, metallic Godspliiter of a headache for the first 24 hours; other than that, nothing for four weeks. Then, at the beginning of week 5, I felt unexplainably lighter, perky, and almost giddy; this lasted for several days. By the end of week five I settled in to feeling normal, i.e., not depressed. The overall experience was like i had taken a welder's mask off and could finally breathe again.

Downside: I felt sleepy much of the time, and orgasms were, well, interesting.

Paxil: Similar to Zoloft without the headache or the perkiness phase.

Downside: overall lethargy, and a non-existent libido.

Lexapro: been on it non-stop for a little more than 5 years. No noticeable side-effects at the 10mg dose. Effect felt at 2 weeks.

A GP suggested upping the dose to 20mg with the explanation that "If you feel OK at 10mg, you'll feel a LOT better if you take 20."

Yes, I'm serious.

I took 20mg for several months and found myself unable to concentrate, or to think with any depth about anything. I also didn't feel significantly better.

Now I buy the 20mg and snap 'em in half.

Congratulations of making the decision to get help. Good luck.
posted by BartonFink at 5:35 PM on September 22, 2007

The rule of thumb is 2 weeks for any real noticeable effects, which seems to correlate with how long it take me to really start feeling better. Maybe it is just in my head though.

And I am just wondering, why are you limiting yourself to an SSRI? If it works, great, but I tried zoloft, paxil, and prozac and they didn't work for me (obviously, I am not you, and I don't think you want to be me :-P). However now I take Welbutrin (which helps with my ADHD a bit as well), which isn't an SSRI and it works great. Do your research, be ready to ask for specifics on certain drugs that you are interested with, but obviously the doctor is going to look at you history to help determine what may be right for you.
posted by slc228 at 9:20 PM on September 23, 2007

Chimin in late, just in case you're still checking up here:

slc228 is right - don't limit yourself to SSRIs. Keep your mind open not only to different types of depression medications, but different forms of *depression.*

My example - I have been on Cymbalta for about six months now. Cymbalta is an SSNRI - selective seratonin norepinephrine reuptake inhibitor. It also minorly effects dopamine.

The pro's are that I just feel BETTER. Took several days for me to start feeling *something* changing - side effects. Two weeks in, the depression started to lift.

The cons - be VERY careful about dosing. Make sure you talk with your shrink about starting low, and 'titrating' up to a dosage that feels good for you. Be very open with your doc about what changes when your dosage increases, so that you can be brought down again if its too much for you.

Also, especially with the SSNRI's, be *very* careful with missing doses. I start having 'withdrawl' effects after 24 hours - I'll get short-tempered or weepy late in the day that I skip. If I miss it the second day, that's when I start getting woozy.

YMMV, of course.
posted by Adelwolf at 2:11 PM on September 25, 2007