Antidepressants are a class of medications that treat anxiety and depressive disorders. According to the World Health Organization, more than 280 million people all over the globe suffer from depression, and antidepressants can assist them in combating the symptoms.

Doctors generally prescribe the lowest dosage of an antidepressant at the time they first begin treating individuals. It can be a difficult process because determining the appropriate dose depends on a variety of variables.

If you’re taking an antidepressant or considering taking one, there are likely to be some concerns; although psychiatric professionals are extremely careful to ensure you receive the best possible care, many patients are concerned about their medications.

If you’re looking for indications that your dose of antidepressants isn’t enough (too low) or excessive (too high), the information below will help. This can be used to inform the doctor in the event that you’re looking to change medication or if you’re doubtful about the dosage of your medication.

Table of Contents

What are Antidepressants and How Do They Work?

Contrary to what they say, antidepressants don’t only serve to treat depression; they’re also employed in treating other anxiety conditions, OCD, or PTSD. Instead of describing the condition they treat, “antidepressants” describe a class or group of medicines that work by balancing the levels of neurotransmitters or chemical messengers in the brain.

There are various kinds of antidepressant medicines that function in slightly differing ways with respect to distinct neurotransmitters; the most popular antidepressants are SSRIs and SNRIs.

The kind of antidepressant and the dosage you’ll take will be determined by factors such as your symptoms, your reactions to the medicine, as well as your health history and family medical history. It is important to consult with your doctor to discover the appropriate dosage and medication that is appropriate for your needs.

Examples of antidepressants that are commonly used:

Prozac (fluoxetine)
Lexapro (escitalopram)
Paxil (paroxetine)
Zoloft (sertraline)
Cymbalta (duloxetine)
Effexor (venlafaxine)
Pristiq (desvenlafaxine)
Savella (milnacipran)
Celexa (citalopram)

Understanding Antidepressant Medication

Antidepressants are prescribed to manage many mental illnesses and disorders. Studies have shown that antidepressants control the amount of certain chemical substances in the brain, either by increasing them or by limiting their functions.

They also target neurotransmitters and can help control the pain. Doctors generally prescribe antidepressants to treat severe and moderate depression.

Types of Antidepressants

In the 1950s, research began to develop prescribed medications for treating depression; this led to the development of five major types of antidepressants.

Monoamine oxidase inhibitors (MAOIs)

Researchers discovered that a drug prescribed to treat patients suffering from tuberculosis was also effective in improving the mood of patients and appetites as well as sleeping patterns; this led to the fact that doctors started using a different version of this drug, iproniazide, for those who suffered from a major depressive disorder.

Antidepressants tricyclic (TCAs)

The first tricyclic drug to be granted approval from FDA U.S. Food and Drug Administration (FDA) to be used in treating severe depression was imipramine in 1959. One of the major improvements related to TCAs was that they were less likely to trigger adverse reactions that many sufferers experienced when taking an MAOI.

Selective serotonin-reuptake inhibitors (SSRIs)

One of the first SSRIs to be recognized by the FDA was fluoxetine in 1974. Brand-name SSRIs with common names that continue to be utilized to this day are Paxil, Zoloft, and Lexapro.

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

After the introduction of Effexor (venlafaxine) in the 1990s, health experts now had another kind of medication available to assist patients who weren’t responding to SSRIs or antidepressants from the past. Other SNRIs with brand names that are being used are Cymbalta and Pristiq.

Atypical antidepressants

The class of antidepressants that are atypical comprises Wellbutrin, Trazodone, and esketamine. As was the case before the development of SNRIs, the development of these drugs offered relief to those whose symptoms weren’t affected by other antidepressants.

Factors Influencing Antidepressant Dosage Determination

Alongside patients’ age, gender, weight, and height, other variables that influence the decision of a doctor to select an antidepressant that is specific to the patient and decide on the dosage:

How certain medications work and influence the brain.
The presence of various physical and mental disorders and ailments.
The side effects of each drug.
How the body responds to the drug.

Signs of an Antidepressant Dose Being Too High

Antidepressants can help patients manage their depression, but the dose that is not right can cause various adverse effects.

Emotional Signs Your Antidepressant Dose is Too High

Emotional Blunting

Emotional blunting is lessening how intense your feelings are; if you aren’t able to feel strong emotions, either positive or negative, this could be an indication that your antidepressant dosage is excessively strong. It is possible that you feel disconnected or disengaged from your own feelings and the feelings of other people.

Increased Irritability

Although some irritability may be a sign of depression, an overly powerful antidepressant dosage can increase anger. If you are angry, snapping at people or having mood fluctuations that are more severe than normal, it may be caused by an excessively high dose of medication.

Heightened Anxiety

While anxiety may be an indication of mood conditions, anxiety that is unrelated to your normal experiences could suggest that your antidepressant dosage requires adjustment. It is possible that you experience racing thoughts, a constant fear, and a feeling of imminent death.

Difficulty Expressing Emotions

If you have trouble expressing your emotions, whether verbally or non-verbally, this may be because of the overly powerful antidepressant dosage. It is possible that you have difficulty communicating with people in a way that is emotional and have difficulty communicating your emotions effectively.

Lack of Interest or Enthusiasm

Although depression may cause a loss of enthusiasm for activities, an overly powerful antidepressant dose could intensify the effect. There could be a complete absence of motivation, interest, and enthusiasm for the things that used to bring you satisfaction.

Changes in Appetite and Sleep Patterns

Although these may be connected with depression and medication changes, dramatic or abrupt changes in appetite or sleeping patterns could suggest that your antidepressant dosage is excessively high. It could be that you experience excessive sleepiness, an increase in appetite, or insomnia and a decrease in appetite.

Behavioral Signs Your Antidepressant Dose is Too High

Restlessness and Hyperactivity

If you find that you’re incredibly nervous, jittery, or have an unending desire to move about, it could be an indication of a high antidepressant dosage. This restlessness may extend to actions like pacing, tapping fingers, or continuously shifting places.

Aggressive Behavior

A high dose of an antidepressant could cause increased irritation and a decrease in the capacity to handle the frustration; this can lead to more frequent outbursts of anger or aggression or impulsive behavior that is not typical of your typical behavior.

Impulsive Actions

The decision-making process that you make on your own, particularly ones that are not consistent with your normal behavior, may suggest that your antidepressant dosage is too high; this may include impulsive spending, risky actions, or sudden changes to plans without taking into consideration the consequences.

Social Withdrawal

Some withdrawals from social interactions could be caused by depression; an excessively high antidepressant dose can cause withdrawal. If you are refusing to socialize, rescheduling plans, or avoiding your usual social gatherings, you might want to consider talking about your medication dosage with your physician.

Difficulty Concentrating

Although concentration issues are not uncommon with depression, a high dose of antidepressants can result in impairment of cognitive functioning. If you’re experiencing difficulty focusing or finishing tasks, it could indicate that your dosage needs to be adjusted.

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that may manifest in both adults and children. ADHD can lead to difficulties with daily life and in educational or professional tasks. While it’s not officially an identifiable condition, paralysis is a frequent manifestation of ADHD that makes it extremely difficult for individuals to finish or start tasks.
Feeling Stuck? ADHD Paralysis: Definition, Signs, and How to Overcome It

Excessive Reassurance-Seeking

If you are constantly looking for a calming influence from others, even in the face of minor issues, it could be due to an overly powerful antidepressant dosage; this could be due to the increased anxiety or feeling of uncertainty.

Compulsive Behaviors

An excessively strong dose of antidepressants can cause compulsive behavior, like routines or actions that you are compelled to do. These behavior patterns could be distressing and can take a lot of time.

Changes in Speech Patterns

Talking too fast, speaking in a hurry, or feeling pressured to talk for a long time could be signs of an extremely strong antidepressant dosage. Your manner of speaking could shift drastically from the way you communicate.

Neglect of Personal Responsibilities

A high dose of antidepressants can affect your ability to take on your professional and personal duties. If you’re not completing tasks you normally take care of, this may be an indication that your dose of medication has a negative effect on your performance.

Excessive Risk-Taking

Involving in risky behavior without thinking about the negative consequences could suggest the dose of your antidepressant is too high. This could include actions like reckless driving, drug misuse, or risky activities.

Physical Signs Your Antidepressant Dose is Too High

Excessive Sedation

Suppose you’re feeling excessively tired, drowsy, or exhausted throughout the day to the point where it affects your functioning. In that case, it may be an indication that your antidepressant dosage is excessively strong. While a few moments of sedation are normal when you first start taking an antidepressant treatment, constant and excessive sleepiness could indicate that you are taking a high dose.

Gastrointestinal Distress

A dose of antidepressants that is too strong could cause gastrointestinal issues like nausea and vomiting, diarrhea, or stomach pain. If you are experiencing the same symptoms repeatedly, this could be a sign that your body’s reaction is adverse to the medication.

Cardiovascular Changes

Certain antidepressants can alter the heart rate and blood pressure. If you notice a dramatic increase in your heart rate or feel dizziness, palpitations, or any other symptoms of cardiovascular disease, it is essential to talk with your physician. These signs could indicate that your antidepressant dosage is too high for your body’s ability to tolerate.

Excessive Sweating

Extreme sweating and unusually high levels, even if it’s connected to physical exertion or extreme temperatures, may be a body response to an excessive antidepressant dosage. The phenomenon of sweating is a common adverse effect of certain antidepressants.

Tremors or Shaking

If you feel tense and shaking of your fingers, hands, or other areas of your body that you did not experience before taking your medication, an over-dosing of your antidepressant dosage could cause this. The tremors could affect fine motor skills as well as daily activities.

Pupil Dilation

A typical dilation of pupils (mydriasis) could be an indication of an overdose of certain antidepressants, especially those that impact serotonin levels. If your pupils appear to be significantly larger than normal, this is an issue to discuss with your doctor.

Muscle Twitching or Rigidity

Muscle-related symptoms such as twitching, spasms, or stiff muscles that were not evident before the start of treatment could suggest an excessively powerful antidepressant dosage. These symptoms can affect your mobility and comfort.

Changes in Appetite and Weight

Changes in weight and appetite are typical when you suffer from depression; an overly high dose of antidepressants can intensify the effects. You may experience dramatic changes in your appetite, which could lead to massive weight gain or loss.

Sexual Dysfunction

Antidepressants can cause sexual side effects like a decrease in libido as well as difficulty in maintaining or achieving sexual intimacy (in males) or having difficulty getting an orgasm. If you notice an abrupt and significant shift in your sexual activity, this could be because of the dose of medication.

Signs Your Antidepressant Dose is Too Low

When healthcare professionals decide on the appropriate dosage for a patient, a variety of factors are taken into account. The individual’s symptoms, along with their medical history and reaction to medications during dosage adjustments, can aid the mental health professional in determining the appropriate dosage.

If someone feels that their dose of antidepressants is insufficient, it is recommended to speak with their doctor. There are a few general signs that could suggest that an adjustment is necessary:

Emotional Signs Your Antidepressant Dose is Too Low

Persistent Low Mood

If you’re still experiencing feelings of despair, sadness, and low mood after taking antidepressants for some time, the dose may not be enough. Antidepressants are designed to reduce these symptoms; consequently, persistent sadness could indicate that the dosage needs to be higher.

Lack of Interest or Pleasure

If you are not interested in the activities that used to bring you pleasure or happiness, this could indicate that your antidepressant dosage does not address your anhedonia (inability to feel joy).

Increased Anxiety

A dose of antidepressants too low can not combat anxiety-related symptoms. If you’re experiencing increased levels of restlessness and anxiety, it could be a sign that your dose requires adjustment.

Cognitive Impairment

Attention problems, memory issues, and cognitive impairments could be indications that your antidepressant dosage is not sufficient. The proper dose must aid in cognitive functioning along with mental clarity.

Feelings of Guilt or Worthlessness

If you’re still struggling in a state of shame and self-criticism despite taking medication, the dose may not be bringing the needed relief from these issues.

Negative Self-Talk

If you’re stuck in a negative cycle of self-talk and self-criticism, then the antidepressant you’re taking may not be able to address these thought patterns. Effective treatment will help to promote an enlightened and positive self-perception.

Limited Response to Positive Events

A deficiency in the dosage of your antidepressant could make it difficult for you to fully enjoy or respond positively to positive experiences. If you’re not gaining the emotional benefits you expect from positive experiences, this could be an indication of a low dosage.

Excessive Mood Fluctuations

While mood swings may be normal, if you’re experiencing intense and rapid changes in mood, it could mean that your current dose of antidepressants does not provide the stability you need.

Behavioral Signs Your Antidepressant Dose is Too Low

Persistent Social Withdrawal

If you’re finding yourself more and more withdrawn from social events and even avoiding contact with your family, friends, or colleagues, it might indicate that your antidepressant dosage isn’t addressing the symptoms. The withdrawal from social activities could mean that your mood has remained at a low level or you’re experiencing an increase in anxiety.

Decreased Interest in Activities

A decrease in enthusiasm and enjoyment for things you normally like can be a behavioral indication that your dose of antidepressants is not enough. If you’re finding it difficult to participate in sports, hobbies, or social occasions, you should talk to your doctor.

Poor Work or School Performance

If your academic or work performance has decreased, this may result from cognitive issues resulting from an insufficient antidepressant dosage. Problems with concentrating on decisions, making the right choices, and keeping your mind organized may make it difficult for you to function efficiently.

Difficulty Completing Tasks

A dose that is not adequate for antidepressants could result in difficulties initiating and finishing tasks. If you’re often starting projects but are finding it challenging to complete these, it could mean that your dose needs adjustment.

Increased Irritability

Although irritability is an indication of depression, if you notice yourself becoming more frustrated, angry, or irritated, it could mean that your antidepressant medication isn’t working to control mood-related issues.

Heightened Anxiety

If your symptoms of anxiety, like excessive worry or restlessness, persist even when you are on an antidepressant medication, it could be a sign that the dose is not enough to treat these problems.

Changes in Appetite and Sleep Patterns

Unchanged or disrupted appetite changes and sleeping patterns could be indications that your antidepressant dosage isn’t able to stabilize these areas in your lifestyle. The effects of depression on eating and sleeping may persist when the dosage isn’t sufficient.

Neglect of Personal Care

A low dose of antidepressants could result in a decrease in the desire to follow through and stay on self-care routines such as bathing, grooming, and dressing appropriately. The absence of these routines may be a sign of chronic depression.

Avoidance of Responsibilities

If you’re avoiding responsibilities, like paying your bills, completing errands, or going to meetings, it could be a signal that your antidepressant medication does not provide the required motivation for you to accomplish these activities.

Physical Signs Your Antidepressant Dose is Too Low

Persistent Fatigue

If you’re constantly experiencing feelings of fatigue even after getting enough rest, it may indicate that your antidepressant dosage does not address mood-related issues. The fatigue associated with depression could persist if your dose isn’t enough.

Insomnia or Sleep Disturbances

Insufficient doses of antidepressants could result in ongoing sleep issues that include problems getting to sleep or staying asleep, as well as getting a good night’s rest. A good treatment will improve the quality of your sleep.

Unexplained Aches and Pains

Physical symptoms like muscular aches, headaches, and joint pain not linked to any other medical conditions may be a sign of a low dose of antidepressants. Physical symptoms associated with depression may persist in the event that the dose is small to ease these symptoms.

Lack of Energy or Motivation

If you’re always feeling low on energy, tired, and physically in a state of disarray to perform daily tasks, it could be an indication that your dose of antidepressants is inadequate to deliver the required mood enhancement.

Changes in Sexual Function

A low dose of antidepressants could result in sexual side effects like a decrease in libido, difficulty having or maintaining an erection (in males), or difficulty having an orgasm. These side effects may persist when the dosage is not sufficient.

Digestive Issues

Certain people suffering from depression suffer digestive symptoms like nausea, vomiting, and stomach pain. If these symptoms continue to persist even after taking medication, it could indicate that the antidepressant dosage isn’t adequately dealing with the problems.

Increased Sensitivity to Pain

Increased sensitivity to physical pain or hyperalgesia may be a sign of an insufficient dose of antidepressants. The proper treatment can help control the perception of pain in people suffering from depression.

Slowed Movement and Reaction Times

In the event that you experience a noticeable reduction in your speed of movement and reaction time, physical coordination may be a result of an inadequate dose of antidepressants that affects your overall performance and energy levels.

Excessive Weight Gain or Loss

A skewed appetite control caused by an inadequate dose of antidepressants could cause significant weight fluctuations. Weight loss or gain that isn’t attributed to any other cause could suggest an antidepressant dose is too low.

Lowered Immune Response

Chronic depression can affect the immune system. If you are suffering from frequent illness and infections or a general decline in the strength of your immune system, this could be due to persistent mood-related issues.

What Should You Do if You Feel Your Antidepressant Dose Is Wrong?

Consult Your Healthcare Provider

The most important step is to talk to your healthcare provider; this may be a psychiatrist, primary care physician, or a mental health specialist. Discuss your concerns regarding the dosage of your medication and the reasons why you believe that it is off. Communication with your healthcare professional is crucial to make informed decisions regarding the treatment you are receiving.

Describe Your Symptoms

You should be specific regarding the signs or side effects you’re experiencing that cause you to think your dosage is improper. It could be mental, emotional or behavioral signs. Give as much information as you can to assist your doctor in understanding your specific situation.

Avoid Abrupt Changes

Do not alter the dose of your medication at your discretion without consulting with your physician. Stopping or reducing abruptly the dose of an antidepressant could cause withdrawal symptoms or worsening of your illness. If needed, your doctor will help you navigate an easy and safe adjustment procedure.

Discuss Adjustments

Your physician will review any symptoms you have, your history of treatment, and any other relevant factors to determine whether your dose requires adjustment. They might suggest lowering the dosage, altering your medication, or looking into alternative treatment options based on your requirements.

Follow Professional Guidance

If your physician suggests a change to the dosage of your medication, adhere to their advice closely. They will give you the steps to alter your dosage in a safe and controlled method.

Monitor Your Response

When your dosage is changed, take note of the changes to your health, either positive or negative. Note the way you feel, whether you’re feeling better or worse, and any possible new side effects that could be observed.

Attend Follow-Up Appointments

Be in touch with your physician with regular follow-up visits; these appointments enable them to follow your progress, determine the efficacy of the dose adjustment, and make adjustments when needed.

Self-Care

When your dose of medication changes, try self-care techniques to help support your physical and mental health. Participate in activities that encourage relaxation, stress reduction, and overall well-being.

Reach Out for Support

If you’re suffering from distressing symptoms or are struggling with the adjustment process, contact your family members, friends, or a professional in mental health to seek help. Support from your family and friends can assist you in navigating this phase more efficiently.

Be Patient

The process of adjusting dosages and finding the appropriate balance may be lengthy. You must be patient and allow yourself time to adjust to changes to your treatment regimen.

Conclusion

The right antidepressant can make a difference in your life and help you function at the highest level; it’s crucial to know that antidepressants are powerful medications that alter how your brain and body function, which means that you could experience negative effects if you are not taking the correct dosage.

There are a variety of indicators that can show that your antidepressant dosage is excessive. If you experience any of these emotional, physical, and cognitive signs, it could be that you need an adjustment period to the drug. Still, the symptoms you experience could be due to a higher dose or lower dose that isn’t effective for your needs. It doesn’t mean you have to stop taking your medication. Instead, speak with your physician to discuss the symptoms. They may alter your dose or prescribe a different medication that will work for you.