I feel low despite taking pills. Should I adjust the dose?

Question

Hello doctor,

I have been experiencing persistent sadness, fatigue, loss of interest, disrupted sleep, and unintended weight loss of about 13.2 pounds (lbs) over the past eight months. I started taking Sertraline 50 milligrams, prescribed by my primary care doctor, three weeks ago but have not noticed much improvement yet.

So my questions are -

How long should I wait before considering a dosage adjustment or change in medication?
Would adding psychotherapy be beneficial now?
Should I undergo lab tests to rule out other causes, such as thyroid problems?
What steps should I take if I develop side effects?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for reaching out.

I understand your concern.

With Sertraline and most antidepressants, it often takes four to six weeks at the right dose to notice meaningful improvements in mood, energy, and interest. At three weeks, it is still a bit early to judge the full benefit.

If there is no noticeable change after six weeks, your doctor may suggest increasing the dose or switching to another medication, depending on your response and tolerance.

It is important to check for other possible medical causes that can contribute to your symptoms. Commonly recommended tests include thyroid function (TSH, free T4), vitamin B12, vitamin D, and iron levels.

Correcting any deficiencies can help improve your energy, mood, and overall recovery. If you experience side effects, especially severe, persistent, or unusual ones, let your doctor know right away.

Mild side effects often improve within the first couple of weeks, but worsening or unsafe symptoms should be reviewed promptly. While waiting for the medication to work fully, try to maintain a regular sleep schedule, eat balanced meals, and engage in light daily activity to support your well-being.

I hope this information helps you.

Thank you.