Areas › Worry and anxiety › Treatment and medication
These medicines work on a timescale of four to six weeks, not days. Say the number out loud at the start, because someone expecting relief this week will have decided by Friday that it failed.
Something does happen on the first day, but it is only the first step of a change that takes weeks to finish. The useful version of this is a date: we will judge it properly in six weeks and not before, and until then we keep going. That one sentence rescues more trials of medication than almost anything else you can say.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
Do not rush to recite before the revelation is fully complete (Quran 20:114). The instruction is to let a thing finish arriving before responding to it.
فَتَعَٰلَى ٱللَّهُ ٱلۡمَلِكُ ٱلۡحَقُّۗ وَلَا تَعۡجَلۡ بِٱلۡقُرۡءَانِ مِن قَبۡلِ أَن يُقۡضَىٰٓ إِلَيۡكَ وَحۡيُهُۥۖ وَقُل رَّبِّ زِدۡنِي عِلۡمࣰ ا
exalted be God, the one who is truly in control. [Prophet], do not rush to recite before the revelation is fully complete but say, ‘Lord, increase me in knowledge!’
Qur’an 20:114read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
Expert recommendations for treating generalised anxiety over the long term describe a condition that usually begins in early adulthood and runs a long course, which is why its treatment is discussed in months and years rather than weeks. The timescale of the problem is simply longer than the one people arrive with. These are recommendations drawn from trials and clinical experience rather than a single study.
Christer Allgulander; Borwin Bandelow; Eric Hollander; Stuart Montgomery; David Nutt; Ahmed Okasha (2003). WCA Recommendations for the Long-Term Treatment of Generalized Anxiety Disorder. CNS Spectrums doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Knowing when to expect a change stops you deciding too early that there will not be one.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
The first week or so on one of these can feel worse rather than better: jittery, restless, sleeping badly. For most people it settles within a fortnight, and it is a known part of starting rather than a sign of harm.
How well something works in the moment and whether it is right for the long run are two separate questions. Fast relief is extremely convincing, which is exactly why it is worth pausing over.
The dose that lifts low mood is often not enough for anxiety, and for obsessive symptoms it is usually well short. Needing more of it is a feature of the problem rather than anything wrong with the person taking it.