|Not everyone, apparently|
This post continues on from my post of 4/14/15 about the practice of psychiatry in the outpatient mental health clinic at the Veterans' Affairs Hospital in Memphis. I retired from my part-time position a few months ago. While the bureaucracy and some of their requirements on physicians were annoying, they were also amusing, if not entertaining, in a perverse sort of way.
Antidepressants, when they work, take 2-3 weeks to start kicking in, and up to six weeks to get the full effect. Often the dose must be increased if the first dose of drug does not work. Different patients may respond to one drug but not another, and to which antidepressant a patient may best respond is unpredictable. Furthermore, certain agents may have serious side effects in a given patient, necessitating a switch to a different one.
Thus, several changes in medication must often be made for some patients. Each time a change is made, the clock for the long 2-6 week kick-in period starts running from the very start all over again.
Therefore, patients started on these drugs need to be followed up within 3-5 weeks at the longest. Dr. X's patients who did not respond to this doctor's initial prescriptions or who had problematic side effects, on the other hand, had to wait months for a follow-up appointment. At that rate, they would often experience no improvement in debilitating depressive symptoms - unnecessarily - for months and months.