Approach to choosing antidepressants

  • Has the patient had a particular response to a certain antidepressant in the past? If yes, consider using that antidepressant.

  • Has there been a family history of response to a certain antidepressant? If yes, consider using that antidepressant.

  • Is there chronic pain? Consider Duloxetine, Venlafaxine.

  • Is there cardiovascular illness? Consider Sertraline.

  • Is the patient on multiple medications? Consider Citalopram, Escitalopram, Venlafaxine, Desvenlafaxine (Pristiq), Vortioxetine

  • Is the patient a child/youth (i.e. less than age 18)? Consider Fluoxetine

  • Is the patient in the perinatal period? Consider Sertraline first; visit or call 1-877-439-2744

  • Is there poor sleep, poor appetite, weight loss? Consider Mirtazapine

  • Is the patient a smoker who wants to stop smoking, and/or wishes to not have any sexual side effects? Consider Bupropion (Wellbutrin)

  • Otherwise, choose any SSRI or SNRI

View information comparing common antidepressants