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 www.motherisk.org 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