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Treatment for Antidepressant Intolerance

Completely resolving depression symptoms, or significantly improving those symptoms, is the goal of antidepressant treatment. However, intolerance to medications is a major cause of unresolved depression. There are several methods of treating antidepressant intolerance.

  1. Cross-tapering

    • One method used by psychopharmacologists is adding a second antidepressant while maintaining the first drug, in an attempt to avoid the negative side affects associated with rapid withdrawal from antidepressant medication. Nausea and fatigue are common withdrawal symptoms, and more serious side effects can occur with monoamine oxidase inhibitor class of drugs. To prevent further complications, the first antidepressant is slowly tapered off and is replaced with the new drug. This approach required caution due to the possibility of negative effects of multiple drugs.

    Treating Side Effects

    • An additional approach is to attempt to manage side effects to make the current medication tolerable. Those medications causing nausea should be taken with food at all times, and medications such as selective seratonin reuptake inhibitors should be taken before bed if they are causing drowsiness and sedation.

    Sexual side effects

    • Intolerance to antidepressants due to negative sexual side effects and sexual dysfunction is a common cause of antidepressant intolerance. Pharmacological approaches to treatment of these problems include switching to medications such as bupropion or nefazodone, which are less likely to cause these symptoms.

    Compliance

    • Another consideration is patient compliance and its role in promoting a positive outcome. Discussion and open dialogue between the psychiatrist and patient regarding expectations and potential side effects is a crucial aspect of medication maintenance.

    Follow-up

    • The role of follow-up care has also been found to be a key aspect of minimizing patient intolerance. Patients who see their physicians for at least three follow-up visits had higher rates of medication maintenance according to an overview of the literature.

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