Q&A: How Many Medications Does Someone With Depression Need?

Q: My doctor recently prescribed more medication on top of what I’m already taking for my depression. Why isn’t the basic medication I’ve already been taking enough? Should I be worried?

A: In my experience I have seen where patients may require a little more than one or two medications to address depression, especially severe depression. Any practitioner worth their salt will tell you that they treat the symptoms of a disorder and not just the disorder. I know some of you are going “huh?” right now, but let me explain.

Although there are medications specifically developed for certain disorders, it is important for a provider to be very clear on what your particular symptoms are so that appropriate treatment is administered and because not everybody with depression has the same symptoms of the illness.

For example, in some persons with depression a loss of appetite is one of their symptoms, but in others an increase of appetite is their symptom. There are some antidepressants that stimulate appetite and others that dampen it; hence, again it is always very important to be very clear and specific about your symptoms when talking to your provider.

Similarly, it sounds like some of your symptoms are not significantly responding to the standard medications, and your provider probably wants to add additional medications for this reason. For instance, I have worked with patients who experienced hallucinations or delusional thought processes related to their depression, and the usual medications used them did not adequately target these symptoms. Often in these cases, a psychiatrist or other qualified health professional added medications to an already established regimen to specifically target these other symptoms and, possibly, other non-responsive symptoms; this practice is commonly referred to as adjunctive therapy.

In addition to all of this, there could be several biological, physical, or other reasons why you are not receiving maximum benefit from your original medication and your medical provider may be able to shed some light on these reasons for you. Although depression is a serious illness, it is one of the most treatable disorders. Just because you may require adjunctive therapy to effectively manage your depression does not mean that you are crazy or any other negative assumption that may run across your mind.  What it does mean is that you fortunately have a provider who is on top of his/her game and is equipped with the knowledge, experience, and skill to help you live a healthy lifestyle!