Here’s why it’s actually possible for a prescription antidepressant to work within 24 hours like a charm.
Antidepressants typically take a while before their effects begin kicking in, sometimes several weeks.
In fact, drugs.com says that it may take “up to four weeks” for Cymbalta.
When I urged my father to convince my mother to take an antidepressant, he said, “It’ll take two weeks before it starts working, and by then, she’ll be fine.”
Being a believer in that possible exception to the rule, I persisted, and finally, after six weeks of bantering with my father, he relented.
And I’ll never forget how I felt when I was walking in the parking lot of the medical clinic towards my car, holding the little bag with the bottle of Cymbalta in it.
I just knew that this antidepressant would start working within 24 hours.
And I was right. The next day, my mother had a look of life in her eyes that I had not seen for almost two months.
She said she “felt human again,” and was talking about baking bread, when just the day before, she could barely get out of bed and spoke of “going into the woods to die.”
And this was no momentary spike in mood; the effect was sustained, though (as predicted by my brother, a pharmaceutical chemist) she ultimately required a few dose increases when the effect began wearing off (this is typical with the induction of an SSRI drug).
So never let the “It will take several weeks to kick in” mantra influence your judgment.
“Typically, SSRI’s take days to weeks to take into effect, depending on their chemical structure and half-life,” says Natasha Fuksina, MD, an internal and integrative medicine specialist who combines traditional, integrative and functional medicine to restore health and function.
“The only plausible explanation beyond placebo for the SSRI to work ‘literally overnight’ would be if your family member used the SSRI with a very short half-life.”
For some individuals, an antidepressant that would normally take a few weeks to start working (like Cymbalta and other SSRI’s on the market) might just, strangely, work like a charm literally overnight.
Though ultimately, my mother’s depression may have been caused, or at least, exacerbated, by hypothyroidism (low thyroid was eventually confirmed with a blood test), we will never know to what extent it was independent from the thyroid disorder.
An antidepressant drug may be the only option left when the patient requires 20 minutes of prodding to simply sit up in bed in the morning, refuses to eat, has frequent sobbing spells and has become non-functional.
You can’t snap someone out of severe depression by denying the problem.
What does “half-life” actually mean?
Dr. Fuksina explains, “For example, venlafaxine (Effexor) has a half-life of four to seven hours.
“Let us look at the basics of pharmacokinetics. A half-life of a medication is the time it takes to eliminate its concentration by 50%. Same time goes for accumulation of the drug.
“It takes four to five half-lives while continuously taking the medication to reach its steady state.
“So if a person took one dose of Effexor, in about four to seven hours after the first dose, the concentration of the drug in the blood would reach 50% of the steady state.
“Sometimes, even half of the needed dose can be effective to help with someone’s symptoms.”
Dr. Fuksina
