Should I Take My Antidepressant at Night or in the Morning?

Does it matter what time of day you take your antidepressant? It may, depending on the specific medication, its side effects, and how it influences your quality of life. Your prescribing doctor may suggest a specific time of day for you to take your antidepressant to minimize any adverse effects that may be associated with that particular antidepressant.

Some antidepressants, such as Celexa (citalopram), Zoloft (sertraline), and  Effexor (venlafaxine) in their sustained-release formulations, do not appear to be any more or less effective when taken at varying times of the day. However, some selective serotonin reuptake inhibitors (SSRIs), the class to which these medications belong, can disrupt sleep for some people and may be best taken in the morning.

For example, the manufacturer of Prozac (fluoxetine) recommends it be taken in the morning because it can make some people feel more energized, especially at the beginning of treatment. On the other hand, when Prozac is given in combination with Zyprexa (olanzapine)—this combination is called Symbyax—as a therapy for treatment-resistant depression, it's recommended to be taken in the evening as it can cause sleepiness.

Paxil (paroxetine) is also generally given in the morning in order to prevent sleeplessness at night. However, it may be given at bedtime if for some reason it causes drowsiness when it's taken in the morning.  Wellbutrin (bupropion) is another antidepressant that is recommended to be taken in the morning in order to prevent insomnia at night.

Certain other antidepressants, on the other hand, generally tend to make you feel drowsy so they're better tolerated if you take them at bedtime. Among these medications are Luvox (fluvoxamine), Remeron (mirtazapine), and the tricyclic antidepressants, including:

• Elavil (amitriptyline)
• Norpramin (desipramine)
• Tofranil (imipramine)
• Pamelor (nortriptyline)

In addition to discussing the time of day that is best to take your antidepressant with your doctor, it's critical to remember that there are other strategies that affect how well your medication will work, including:

• Have patience. Antidepressants take time to work, anywhere from 6 to 12 weeks for the full effect, although many people notice improvement within a week or two. So when you start your antidepressant, keep in close touch with your doctor and stay positive—you can find a way to treat your condition, but it may take a little bit of trial and error.
• Stay consistent. Take your antidepressant as directed at the same time every day and do not stop it without first talking to your doctor. If your antidepressant is causing side effects, remember that many, if not all of them, will go away with time. If the side effects are intolerable, get in touch with your doctor right away, as there is a solution—often a dose change, switching to a different antidepressant, or adding a second medication to soothe the offensive side effect.

The big picture here is that taking an antidepressant needs to be part of a well-thought-out plan with your doctor to maximize its benefits and minimize any potential side effects. If you're currently taking one of the medications listed in this article and you think you might need to change the time of day at which you take it, you should not attempt to make a change in your treatment plan without consulting with your doctor first. The recommendations noted here are general and may or may not be applicable to your own unique situation as everyone responds differently to medication. Your doctor will be able to provide you with specific recommendations about whether your antidepressant should be taken at a particular time of day for the best results.

Sources:

Medline Plus. Fluoxetine. U.S. National Library of Medicine. Updated August 15, 2017.

U.S. Food and Drug Administration (FDA). Depression: FDA-Approved Medications May Help. Updated December 12, 2017.

Zhu LL, Zhou Q, Yan XF, Zeng S. Optimal Time to Take Once-Daily Oral Medications in Clinical Practice. International Journal of Clinical Practice. October 2008;62(10):1560-71. doi:10.1111/j.1742-1241.2008.01871.x.