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

Determining if you should take your antidepressant at night or in the morning depends on the specific medication you're taking, 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 common adverse effects—primarily insomnia or drowsiness—that may be associated with your particular prescription.

Some antidepressants—such as Celexa (citalopram), Zoloft (sertraline), and Effexor (venlafaxine)—have sustained-release formulations, and 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 would 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.

Paxil (paroxetine) is generally taken in the morning in order to prevent sleeplessness at night. However, it may be given at bedtime if it is found to cause drowsiness in a particular patient when 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.

Unlike some SSRIs, certain other antidepressants 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)

If you experience sexual side effects (low libido, erectile dysfunction, or inability to ejaculate) from your antidepressant, the timing of when you take your antidepressant can make a difference. Taking medications like Zoloft (sertraline) or tricyclic antidepressants after you have sex may ensure the levels of the drugs in your body are lowest.

Some classes of antidepressants (mostly SSRIs) can trigger nausea as well as vomiting, diarrhea, and loss of appetite. While this often resolves itself as your body adjusts to the medication, sticking to a nighttime medication schedule can also help. This way you'll hopefully sleep through any digestive woes.

When prescribed in children or adolescents, Zoloft can cause frequent urination as well as urinary incontinence. In this case, taking the pill in the a.m. can prevent any nighttime bedwetting.

In addition to discussing with your doctor the time of day that is best to take your antidepressant, 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; potentially anywhere from 6 to 12 weeks for the full effect, although many people notice improvement within a week or two. 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.
• Address side effects. 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, such as a dose change, switching to a different antidepressant, or adding a second medication to soothe the offensive side effect.

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.

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.