Am I Taking Too Much Antidepressant Medication?

Am I Taking Too Much Antidepressant Medication?

Antidepressants are very powerful and if you are prescribed an agent which very effectively locks onto your biochemistry, it will completely obliterate your depression and anxiety symptoms.  However, there is then the possibility, that having no symptoms left to absorb the medication, the medication will start to affect you personally. 

Symptoms which suggest that you are being over-medicated include:-

1. yawning a lot.
2. being drowsy.
3. falling asleep when sitting in a comfortable position.

NB: Many people with depression feel very tired, but they do not yawn or actually go to sleep inappropriately in most cases.

1. Difficulty finding the right word when thinking.
2. Difficulty finding the right word when talking.
3. Making simple mistakes in spelling or mathematics that you would not normally make.

In the case of over-medication, reducing the dose of your antidepressant for a few days will very quickly solve the problem.  If in fact the problem was not due to excessive medication, you will also notice within a few days that your symptoms are worse, indicating the cause of your symptoms has to be reconsidered.

Gradual reduction of antidepressant dosage

If it does seem you are over-medicated, it may be appropriate to reduce your antidepressants.  However, with most SSRIs and with Effexor, very unpleasant flu’ like symptoms can occur if you stop the medication abruptly.  With most antidepressants therefore, (with the exception of Prozac which lasts a very long time in your blood stream), you would probably be advised by your doctor to reduce the dose somewhat, rather than stopping the medication completely for a few days.  Although this approach lessens the chances of you getting a withdrawal reaction, it does mean it will take somewhat longer for the symptoms of being over-medicated to subside.

Need to adjust the dosage of antidepressants

Depressive illness is a stress-induced phenomenon and antidepressants are a coat of armour against the stresses of life.  In a battle, you would want to carry with you as thick a coat of armour as you could tolerate, provided you were not being made too exhausted by carrying it around.

The ideal situation, as described in textbooks of psychiatry, is that you find a dose of antidepressants which has eradicated your symptoms and you take this same dose for many months or years.  

However, in my experience, the above scenario only rarely applies.  When people are under stress, their symptoms of depression tend to slowly creep back and it is necessary to increase the antidepressant dosage slightly to compensate.  Typical early symptoms of depression returning are difficulty thinking clearly, difficulty with memory, reduction in sexual interest, general fatigue and lack of motivation.

In contrast, when life is not so stressful, or when the antidepressants have eventually eradicated your depression and particularly the accompanying anxiety, many people find they start to feel very tired and flat.  They are sometimes told the antidepressant must be losing its effect and that they should change antidepressants or increase the dosage.  For some antidepressants, this has been described as the “therapeutic window” of that medication.  In fact, in my experience, all that is happening in many cases is that the medication has proved to be too strong for the few remaining symptoms. The person is now being over-sedated by the powerful antidepressant and all that is needed is to reduce the dose of the antidepressant. 

Typical symptoms of being over-medicated are feeling tired, having difficulty thinking of the right word, having difficulty saying the right word, making simple mistakes in spelling or calculations, yawning or falling asleep as soon as one sits in a comfortable position.

With experience, I advise my patients to slightly adjust the doses of their own antidepressant medication, up or down, depending on whether they are experiencing return of depressive symptoms, or being over-medicated.

What if my depression returns when I reduce the dose of antidepressant?

Occasionally, it happens that a dose of antidepressant required to keep your depression at bay causes drowsiness or some of the above other symptoms of over-sedation, but reducing the dosage of the antidepressant causes the depression to return to a certain extent.  The usual response in this situation is to consider changing the antidepressant medication, but this is a prolonged and often complicated procedure.

Your doctor may be willing to consider the unusual but effective technique of giving you low dose DEXAMPHETAMINE, a stimulant medication which will overcome the sedation due to the antidepressants, so that you can tolerate the necessary dose of the antidepressant.  However, there are legal controls and certain precautions needed with the use of this medication.

Important Disclaimer:  This site is medical information only and is not to be taken as diagnosis, advice or treatment, which can only be decided by your own doctor.