Signs Your Antidepressant Dose is Too Low or Too High

Finding the proper dosage for your antidepressant is crucial to treating your depression symptoms effectively. When used appropriately and at the correct dosage, antidepressants can be life-changing. However, if your antidepressant dosage is too low, you might be left trying to manage unresolved depressive symptoms like lack of motivation, lingering depression, uncontrollable crying, or sleepless nights. On the flip side, when an antidepressant dose is too high, you might feel disconnected from the world and people around you.

Finding that “dosage sweet spot” means being aware of both positive and negative changes in your mood and daily functioning after you start taking an antidepressant. From a high-level perspective, your meds are probably on point if your therapy sessions are working and you have more energy, time, and motivation for friends, relationships, and hobbies. If things seem a bit off, though, it might be time to consult your mental health professional about what you’re experiencing so you can discuss if you need a dosage adjustment. 

Keep reading to learn how to spot telling signs your antidepressant dose is too low or too high.

Signs Your Antidepressant Dose is Too Low

Antidepressants can be game changers when it comes to managing depression symptoms, but if you’re still weighed down with feelings of hopelessness or despair after taking them for a while, your dose might be too low. Learn when to increase antidepressant dosage by paying attention to certain signs.  

“The logic and rationale for using medication to address any medical illnesses is to resolve the symptoms. It is counterproductive if a medicine prescribed in a subtherapeutic dose does not effectively treat the symptoms. After a few weeks of starting medicine, if there is no change in symptoms (provided medicine is taken as advised by the doctor regularly and without missing doses), inform your doctor to address the dose change.”

– Talkspace psychiatrist Dr. Muhammad Munir 

Persistent symptoms of depression

Signs your antidepressant dose is too low can include persistent symptoms of depression like deep or an increasing sense of sadness or a lack of pleasure in life, especially in things you once enjoyed. 

An increase in depressive symptoms is another red flag your medication isn’t working like it’s supposed to. This can be because you’re on the wrong dosage, or it might be because you need an entirely different prescription medication (only a qualified mental health professional can accurately determine which is true).

Lack of improvement over time

Antidepressant treatment works over time. While you likely won’t experience an immediate and total relief in symptoms when you first start taking prescription medication, over time, you should feel improvement. 

Not all depression medication will work the same way or follow the same timeline for everyone, but most people see at least some improvement in their mental health condition within a couple of weeks. If you’ve been taking an antidepressant for longer than a few weeks and you don’t feel any better at all, you should talk to your doctor. 

Return of anxiety or insomnia

Depression can cause anxiety or insomnia. If you’ve taken an antidepressant for longer than a month but are still feeling symptoms of anxiety or having several nights of insomnia each week, you might need to ask your doctor to increase your dose. 

Signs Your Antidepressant Dose is Too High

With any medication — including antidepressants — more is decidedly not better. When an antidepressant dose is too high, your body will send clear signals that something isn’t right. If you recognize any of these signs your antidepressant is too strong, talk to your doctor about dosage adjustment. 

Excessive fatigue or drowsiness

Feeling like you’re trying to push through a thick fog or struggling to stay awake during the day might mean your brain is getting a dose way higher than it needs. Take note if you suddenly need to nap more frequently, especially if it’s increasingly difficult to stay alert during activities that were once engaging. 

Feeling overly numb or detached

There are emotional side effects of taking an antidepressant that’s too high in dosage, too. This can result in feeling numb or detached from your world and the people in it. A feeling of disconnect isn’t a normal — or healthy — response to antidepressant medication.  

Physical side effects

You can have physical side effects to a medication not being at the correct dosage. For example, you might experience things like digestive system issues, changes in appetite, headaches, or sexual dysfunction. All of these can be the body’s way of telling you the balance is off when it comes to your antidepressant.

Agitation or increased anxiety

One of the more common signs your antidepressant dose is too high is feeling increasingly agitated or like your anxiety is worsening. This can be incredibly frustrating since the whole reason you’re taking antidepressants is to relieve disruptive symptoms like these. Fortunately, a quick change to your dosage might be all it takes, so be sure to let your doctor or therapist know right away if you’re feeling more agitated than normal lately. 

Signs Your Antidepressant is Working Just Right

When your antidepressant is working how it should, it can be life-changing. If you feel like the cloud of depression has lifted, your medication is probably exactly where it needs to be. Optimal dosage can maximize the benefits of medication while minimizing side effects. In short, the right antidepressant, at the right dose, can make life feel like it’s worth living again.

There’s no magic timeframe in terms of knowing if an antidepressant is working or not. Different medications can vary in how long antidepressants take to work.

• Selective serotonin reuptake inhibitors (SSRIs) might take up to 6 weeks before you feel the full effects. 

• Serotonin and norepinephrine reuptake inhibitors (SNRIs) can take 1 – 4 weeks, on average. 

• Tricyclic antidepressants (TCAs) typically work in about 2 – 4 weeks.

• Monoamine oxidase inhibitors (MAOIs) might offer relief anywhere from 2 – 6 weeks.

While the timeline may vary for medication effectiveness, the signs below indicate your antidepressants are working.

Improvement in mood and outlook

This is the most obvious sign that your antidepressant medication is at the right dose. A noticeable boost in mood and outlook can mean you’re more optimistic and less irritable, and you might feel more emotionally stable.

Decrease in original symptoms

It’s important to note that not everybody will experience every symptom of depression — but if your original symptoms have improved, your current dose is probably appropriate. Common symptoms of depression include persistent sadness, loss of interest in things you once enjoyed, and an increase in fatigue, among other things.

Manageable side effects

When an antidepressant is dosed correctly, its side effects shouldn’t be overwhelming. While you want relief from depression, you don’t want the impact of your medication to be worse than your symptoms. Antidepressant side effects can vary depending on several factors, including body chemistry, other medications you’re taking, coexisting conditions you might have, and more. 

Some of the more common side effects to be aware of include:

• Nausea
• Headache
• Sleep disturbance
• Change in appetite
• Dizziness 

Greater motivation for daily tasks

Depression can leave you feeling unmotivated, so even simple daily tasks start to feel overwhelming or like a chore you just can’t seem to tackle. 

If you see a noticeable change in your drive and ability to tackle everyday responsibilities, it might be the result of your medication. When they work, antidepressants can give you energy and motivation to get through your day.

Restored interest in activities

A common symptom of depression is losing interest in activities, especially those you once enjoyed. A positive sign that your antidepressant is at the proper dose is that you feel a renewed enthusiasm for your life, the people in it, and the things you used to get great pleasure from doing. 

Therapy is getting more effective

When medication is working properly, it often enhances the effectiveness of talk therapy sessions, creating a more synergistic approach to treatment. In a meta-analysis looking at a combined approach to depression treatment using both therapy and medication, there was a clear indication that incorporating psychotherapy and medication into a comprehensive treatment plan will be much more effective than when one is used without the other. 

While the right type and dosage of a drug can be very effective in relieving symptoms, therapy for depression can offer tools and coping skills to manage your daily life and relationships.  

“It has been proven through decades of research that medicine and therapy combined have the most effective and lasting impact. Medication helps with the physiological symptoms of depression (sleep, appetite disturbance, irritability, agitation, poor motivation, crying spells, etc.), while psychotherapy helps to establish the psychological mechanisms (coping skills, problem-solving, improving response to stress, cognitively addressing an emotional situation, etc.). Medicine gets you to the door, but you open the door and use therapy to get out of the depression. Medicine brings up the motivation to work on the therapeutic tools that you are learning in therapy.”

– Talkspace psychiatrist Muhammad Munir  

Talk to a Mental Health Provider About Your Dosage

If you’ve been taking your antidepressant as prescribed for longer than 4 to 6 weeks but are still experiencing unwanted or new side effects, talk to your doctor about possibly altering your dosage or trying a new drug. Finding the proper dosage can take some time, but it’s possible, and when you succeed, you’ll be able to get back to a life without depression ruling your every move. 

The first step in determining the right dosage is finding a psychiatrist or doctor to help you. They’ll assess signs your antidepressant dose is too low, too high, or just right. Talkspace makes it simple to connect with an online psychiatrist for prescription drugs and medication management when treating depression. 

Whether you’re just starting an antidepressant or you’re already on one but feel like it’s not working, Talkspace can help with a plan to adjust your medication until you’re getting optimal results. Reach out to Talkspace today to discuss a plan for increasing or tapering your current medication safely — and never, ever abruptly stop any antidepressant without first talking to your doctor.