As seen clinically, most patients start responding to an antidepressant within 7-14 days of starting the treatment and by the end of 4-6 weeks, noticeable improvement can be seen if that patient is responding to the antidepressant in use.
Few patients who have an initial response with a particular antidepressant may relapse even though they continue treatment and we call it is "poop out". In such cases, the usual strategy is to either increase the dose / add
another antidepressant or add an additional antidepressant to augment the effect of previous antidepressant.
Probably you are also experiencing the same. As you were responding well to 100 mg of Pristiq which is the maximum prescribed dose, but have now stopped responding to it so now there are two options in your case.
1 - Add another antidepressant like Bupropion or Mirtazapine to augment the effect of Pristiq. If you are experiencing excessive sleepiness, fatigue, lack of concentration, poor memory then adding Bupropion will help a lot. Otherwise if you are experiencing sleeping
difficulty than Mirtazapine can be a useful addition to Pristiq.
2 - Replace Pristiq by some other antidepressant like Cymbalta or another SSRI antidepressant like Fluoxetine or Sertraline.
You can discuss with your doctor about these possible options and hopefully you will recover soon.
In addition to medicines, you can also try Cognitive Behavior Therapy if you have not tried it already.
Cognitive Behavior Therapy can bring long lasting benefit in your thinking pattern and the resultant depression and negativity.
I am giving you a link to a websites which provide free online CBT.
MoodGYM (https://moodgym.anu.edu.au/welcome )
[A free self help program to teach cognitive behaviour therapy skills to people .]
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