Antidepressants

A wide range of feelings and beliefs influenced people we interviewed when deciding whether to begin taking an antidepressant. Some believed and trusted their doctor and preferred to be guided by him or her. Some saw the decision to take the antidepressant as relatively straightforward, but others took a while to decide.
 

 
An antidepressant can offer the potential to alleviate symptoms and people deciding whether to take a course often say it gives them a sense of relief and hope for the future. Deciding to take an antidepressant can feel like a positive step. For some, there is an overwhelming motivation to start ‘tackling the problem’ and to do something that could help lift their mood. The first time Collette was prescribed an antidepressant she said she was willing to try anything that could help with her symptoms and that she wasn’t well enough to think about it too much ‘I didn’t want to feel like I was feeling… so... yes why not give it a go and I really couldn’t be bothered either way, it was just easier to take the pills’. People talked about ‘just wanting to feel normal’ again’, ‘feeling like I couldn’t carry on’ ‘needing help straight away’ or feeling ‘desperate’ for something that might help.
 
Others we spoke to took time deciding whether or not to go ahead and said they ‘wavered’, or ‘dithered’ about it for a while. Some people had always felt they should be able to deal with depression without medical intervention ‘it’s a crutch... willpower’ and felt that deciding to use an antidepressant was betraying themselves, or giving up (see ‘Feelings about using medication for depression’). People described balancing ‘pros and cons’ when deciding whether to go ahead, for example weighing up perceived benefits against fears about side effects, feelings about stigma, or whether they might become ‘hooked’.
 
 
Sometimes even when people had collected their medicines from the pharmacy they did not begin taking the tablets immediately. Reading the list of side effects in the patient information leaflet made some worry that taking an antidepressant might make things worse. Hannah read the leaflet and was unsure about whether to go ahead because "it says it can cause suicidal feelings.... if you weren’t already feeling suicidal is it worth the risk?" (See also ‘Patient Information leaflets’).
 
Melanie read the leaflet in the packet "front and back… to make sure I knew exactly what could happen to me in the course of taking them". Greg wondered whether his doctor should have spent more time talking to him before handing him a prescription and after he collected the tablets he kept looking at the box wondering whether or not to start taking them. They talked about a range of considerations including uncertainties about how the medicine might make them feel, how long it might take to work, how long they might need to take it, fears about potential side effects, about becoming reliant on medication, or wanting the opportunity to try therapy first.
 
Even after deciding to go ahead, actually swallowing the tablet for the first time could feel like a big decision. Greg said once you’d decided you had to have some faith and ‘believe in it’.
 
 
Finding out more about the medicines that have been prescribed, and talking it through with the GP can help people to decide (see also ‘Antidepressants - finding information’ and ‘Being prescribed an antidepressant’).
 
 
Past experiences of using a particular antidepressant can influence people’s decisions about taking it again. Lou had taken Prozac (fluoxetine) when she was younger: it had increased her anxiety levels and made her feel worse, so when she returned to the GP some years later she told him she was reluctant to take it again. Her doctor explained that she could try others that that would not have the same effect.
 
 
People can also feel unsure about what to expect, and it can be difficult to make decisions and think things through when you’re experiencing depression (see also ‘Getting to the doctor -seeking help for depression’ and ‘Being prescribed an antidepressant’).
 
While appointments with GPs increasingly involve ‘shared decisions’ we talked to both younger and older people who told us that this hadn’t been the case for them. Olivia Y, for example, said she hadn’t felt she had an opportunity to make a decision as a teenager ‘you don’t question it, when a person in front of you is called a doctor you just do it, especially when you’re a child’. Now though she says she wants to know more about medicines before deciding whether to take them. Some older people said they had always believed that the ‘doctor knows best’. Michael has taken an antidepressant most of his adult life on the advice of his doctors and had been too overwhelmed by his depressive symptoms to be able to make decisions ‘I was very accepting, it was just an overall battle to keep going each day, a struggle’.
 
People who are in hospital with severe depressive symptoms may feel so unwell that they don’t know what medicines they are getting and it can feel as though there is little choice. Olivia X did not agree with her doctor’s diagnosis and refused to take the medicine that he said she needed. Her refusal to comply resulted in a chain of events leading to a hospital admission under a ‘section’ of the Mental Health Act (1983). She felt that decisions about her treatment were effectively removed from her control. Thomas worried that if he didn’t take the medicines he had been prescribed, that his doctors might commit him to hospital, so while he collected the prescriptions from the chemist he decided not to take them. ‘I thought if I can be seen to be compliant to treatment it would make me less likely to be sectioned’. (See also ‘Antidepressant use and hospital care’).
 
Making decisions about using antidepressant medicines is an on-going process and people’s views about taking a particular medicine may change over time (see also ‘Managing the use of antidepressants’, ‘Stopping taking antidepressants’, ‘Changing antidepressants’ and ‘Reviewing antidepressant use’).

Last reviewed June 2016.
Last updated June 2016.