Should I start an antidepressant? Let's get you ready to decide.
For anyone weighing an antidepressant — for themselves, or helping someone they care about think it through.
An antidepressant is a prescription medicine that can help with depression and some anxiety conditions. This page doesn't tell you whether to start one — that's your call, and your GP's, together. It hands you the questions to bring, including the two most people never think to ask: how you'll know if it's working, and how you'd come off it later. You walk in to decide, not just to nod yes or shake your head no.
It isn't a calculator and it doesn't say "yes you should" or "no you shouldn't". It never works out a diagnosis, never names a specific medicine, brand or dose, and never tells you what to do. The decision is start · not yet · not for me — your choice, informed.
The four questions to bring to your GP
Benefits — What's the actual chance this helps me, in numbers — and is my depression mild, or moderate-to-severe?
Risks — What side effects are common in the first couple of weeks, which ones settle, and which ones mean I should call you?
Alternatives — What are my other options — talking therapy, lifestyle changes, or therapy alongside medication — and what would you suggest first?
Nothing / wait, and the plan to come off — What happens if I wait? And if I start, how long would we plan to stay on it, when would we review, and how would I come off it safely?
If you need to talk to someone now: Lifeline 13 11 14 or text 0477 13 11 14 (24/7) · Suicide Call Back Service 1300 659 467 · 13YARN (First Nations) 13 92 76 · 1800RESPECT 1800 737 732 · Poisons Information Centre 13 11 26 · In an emergency call 000.
Dr HB Lo
Integrative GP · Starting an antidepressant — decision aid (BRAN card)
Your situation
The one most people forget to ask:
The four questions to ask — then decide
Benefits — the real number, for someone like me
Risks — the common downsides, and how common
Alternatives — what else is on the table
Nothing / wait — and the plan to come off
Your note to raise
The honest part
The honest part — none of this means don't take the medicine.
Antidepressants genuinely help a lot of people, especially with moderate-to-severe depression. Three honest things to hold alongside that:
Starting young needs closer watching. In people under 25 there's a small increased chance of suicidal thoughts in the first few weeks — which is exactly why close monitoring early on matters (TGA; RANZCP). It's a reason to start safely with a plan, not a reason to refuse.
They're not instant, and they're not for everyone. The benefit is real for moderate-to-severe depression but smaller, sometimes minimal, for mild symptoms, where therapy and lifestyle changes can work as well or better (RANZCP; Cochrane).
Coming off them needs a plan. Around half of people who stop get some withdrawal-type symptoms, and stopping slowly (a careful taper) makes a big difference — so it's worth agreeing the start and the eventual finish up front (RACGP-endorsed Maudsley deprescribing guidance; RELEASE toolkit).
These questions aren't a challenge to your doctor. They're the ones doctors ask for their own family. Asking them out loud just gets you the conversation faster.
Take it with you
Email yourself the one-page question card to bring to your GP.
Your four questions with room to write the answers, the key question boxed at the top — ready to put on the desk.
I'll also send the occasional drhblo email. Unsubscribe anytime.
Your answers stay on your device. If you email the card, only the card is sent — not anything you typed in the note box.
If you want to go a step further
Want to see what "about 1 in 7" actually looks like for 100 people — the benefit and the side-effect numbers side by side? The antidepressant-numbers visual turns the percentages into people. And if you're still weighing whether it's even worth raising, the mood check-in gives you a score and an opening line to bring in.