What to Do When Your Antidepressant Stops Working
It was working. You finally felt like yourself again. The fog lifted, the heaviness faded, and life felt manageable.
And then it stopped.
The symptoms are creeping back. The medication that saved you doesn’t seem to be doing its job anymore. And you’re wondering: Is this normal? Did I do something wrong? Am I back to square one?
The Short Answer:
If your antidepressant stopped working, you’re not alone. This happens to 25-30% of people on antidepressants. It’s called “tachyphylaxis” or “poop-out.” The solution isn’t to quit or double up on your own; it’s to talk to your provider about adjusting your dose, switching medications, or trying genetic testing to find what works better for your biology.
First, take a breath. This happens more often than you think. And there are solutions.
Why Antidepressants Stop Working
This phenomenon has a name: “antidepressant tachyphylaxis” or “poop-out.” It happens to an estimated 25-30% of people on antidepressants at some point.
There are several reasons why a medication that worked before might stop working:
Your brain chemistry changed. Your brain is constantly adapting. Over time, it may adjust to the medication in ways that reduce its effectiveness.
Your life circumstances changed. A new stressor, such as job loss, relationship problems, grief, or health issues, can overwhelm what your current dose was managing.
You’re metabolizing the medication differently. Changes in diet, other medications, supplements, or even aging can affect how your body processes antidepressants.
The depression evolved. Mental health conditions can shift over time. What started as one type of depression may have changed into something that needs a different approach.
Inconsistent dosing. Missing doses or taking them at irregular times can reduce effectiveness. Be honest with yourself about whether you’ve been consistent.
The important thing to know: this isn’t your fault, and it doesn’t mean medication won’t work for you.
Signs Your Antidepressant May Have Stopped Working
How do you know if it’s the medication or just a bad week? Look for patterns:
- Symptoms returning gradually over weeks or months
- Feeling like you’re “back where you started”
- Needing more effort to do things that felt easier before
- Sleep, appetite, or energy changes are creeping back
- Increased irritability, hopelessness, or emotional numbness
One bad day isn’t a sign your medication stopped working. But if you’ve noticed a consistent decline over several weeks, it’s time to talk to your provider.
What NOT to Do
When symptoms return, the instinct is to take action. But some actions make things worse:
Don’t stop your medication suddenly. Quitting cold turkey can cause withdrawal symptoms and make depression worse. Always taper under medical supervision.
Don’t double your dose on your own. More isn’t always better. Changing your dose without guidance can cause side effects or other problems.
Don’t assume nothing will work. One medication failing doesn’t mean all medications will fail. There are dozens of options.
Don’t wait too long to get help. The longer you let symptoms build, the harder they are to treat. If something feels off, reach out.
What TO Do Instead
Contact your psychiatric provider. This is exactly what they’re there for. Medication management isn’t a one-time thing; it’s an ongoing process of adjustment and optimization.
At MindWell, medication management includes regular check-ins to catch these issues early and make adjustments before symptoms get out of control.
Be specific about what’s changed. When you talk to your provider, come prepared. Note when symptoms started returning, what they feel like, and any life changes that might be contributing.
Discuss your options. Your provider might suggest:
- Increasing your current dose
- Switching to a different medication
- Adding a second medication to boost the first one
- Trying a different class of antidepressant
- Adding therapy if you’re not already doing it
Consider genetic testing. If you’ve tried multiple medications without success, genetic testing can reveal how your body metabolizes different drugs. This takes the guesswork out of finding what works.
The Role of Genetic Testing
Not everyone responds to medications the same way. Your genes affect:
- How quickly you metabolize certain drugs
- Which medications are likely to cause side effects
- Which antidepressants are most likely to work for you
At MindWell, we offer pharmacogenomic testing that analyzes your DNA and provides a personalized report. This helps us choose medications based on your biology, not trial and error.
If your antidepressant stopped working and you’re facing the prospect of trying something new, genetic testing can save you months of frustration.
When to Seek Immediate Help
Most medication adjustments can wait for a scheduled appointment. But seek help right away if:
- You’re having thoughts of suicide or self-harm
- You’re unable to function at work or home
- You’re using alcohol or drugs to cope
- You feel completely hopeless or out of control
If you’re in crisis, call 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room.
You’re Not Starting Over
It might feel like you’re back at the beginning. But you’re not.
You know medication can work for you, because it did. You have more information now about what helps and what doesn’t. And with the right provider, you can find a solution faster than you did the first time.
At MindWell Psychiatric Services in Las Vegas, we specialize in helping people navigate exactly this situation. Michael Kuron, MSN, APRN, PMHNP provides personalized medication management and works with you to find what works, without the guesswork.
Contact MindWell Psychiatric Services to schedule an appointment. Let’s get you back on track.
FAQs
Why did my antidepressant stop working?
Your brain chemistry adapts over time, which can reduce the medication’s effectiveness. Other factors include life stressors, changes in how your body metabolizes the drug, or the depression itself evolving. This is common and doesn’t mean medication won’t work for you.
How common is it for antidepressants to stop working?
Studies suggest 25-30% of people on antidepressants experience this at some point. It’s sometimes called “antidepressant tachyphylaxis” or “poop-out.” It’s frustrating, but it’s a known phenomenon with solutions.
Should I stop taking my antidepressant if it's not working?
No, never stop suddenly without medical guidance. Quitting cold turkey can cause withdrawal symptoms and make depression worse. Talk to your provider first about tapering or switching safely.
How long does it take to find the right antidepressant?
It varies. Some people find the right fit quickly; others need to try several options. Genetic testing can speed up this process by identifying which medications are most likely to work for your biology.
Can genetic testing help if my antidepressant stopped working?
Yes. Pharmacogenomic testing analyzes how your body metabolizes different medications, helping your provider choose options that are more likely to be effective and cause fewer side effects.
