Oh No—I Forgot To Take My Antidepressant Today!

RED ALERT! Sound the alarms! Batten down the hatches! I forgot to take my antidepressant!

The above panic was me earlier this week. I take an SSRI antidepressant each day when I wake up in the morning—it has been part of my daily routine for the past year. I even got myself a day-of-the-week pill box to help remind me if I took my medication or not. I’ve been great at staying consisten

However, last Tuesday when I was about to go to bed, I saw it: the Tuesday box had been unopened.

Cue: cold sweats and anxiety.

What should I do? I had a lot of questions:

• Do I take the medication now, right before going to bed? Or do I wait until morning?
• How many pills do I take in the morning?
• What will happen to me now that I forgot to take my medication?

The answers may not be the same for everyone, or for every medication. For that reason, to get the best answer for you, you will have to discuss with your doctor or pharmacist what to do in the event you forget your medication.

My medication came with directions for a missed dose: I was to take it as soon as I realize I missed it UNLESS it is close to when I would take my next dose. Given that it was late at night for me, I decided to wait until the morning.

Now the next question: Should I just take my normal one pill tomorrow, or do I double up to make up for the dose I missed? According to my doctor, it is not a good idea to double up my specific medication—instead, just take one dose like I normally would.

So, the last question: How will this affect my functioning? What happens now that I missed a dose?
Again, this will depend on the medication you take, the dose that you take, and how your body handles medication.

The drug I take, Zoloft (sertraline), has a half-life of 26 hours. This means that when I take my dose in the morning, it will take my body 26 hours to eliminate half that dose; and then it takes another 26 hours to eliminate half of the half-dose left in my body. Theoretically, when I missed that Tuesday dose, by the Wednesday morning that I took my next dose, I had about one-fourth of my usual medication level in my system.

Another thing to consider is how fast the medication takes effect. It takes my medication four to eight hours to reach its peak level in my circulation. Therefore, I expected that there would be a few hours during that day in which I would have an unusually low level of circulating Zoloft in my system, and it might be the case that I could experience some effects of missing the medication.

My expectations were correct. There was about a 1.5-hour period where I started to feel a little dizzy, muscle weakness, and possibly some nausea. However, these feelings did go away as the day went on and my next dose took effect.

Woo-hoo, I survived a day of missing my medication! And I learned that there are certain things I can do to prepare for any future missed doses of medications:

1. Check with my doctor/pharmacist beforehand to find out when to take my next dose.
2. Also check with the doctor/pharmacist to determine if I take a regular dose the next time or not
3. Expect that it may be likely that I could experience some short-lived and minor negative side effects, but know that these will pass within a short period of time

Have you ever missed a dose of your medication? Did you know what to do when this happened? Feel free to share your experiences in the comments below!