Visit the Anxiety Algorithm Website About Contact Print
  • Home
  • Algorithm Content
  • Medications
  • Instructional Video
  • Medications Video
  • Email this page
  • Visit the Anxiety Algorithm Website
  • About
  • Contact

Table of Antidepressant Medications (Adults)

Email this page
Click the algorithm buttons for more info.
Enlarge Shrink Hide Show Algorithm

Choosing an antidepressant medication          Switch medication       Increase, Augment or Switch        Drug Interactions Checker



Medication brandname
Starting dose
(usually in am)
Initial target dose
Max dose*
Anti-cholinergic
Sedation
Insomnia / Agitation
Orthostatic Hypotension
QT
GI
Weight Gain
Sexual
Comments
SSRI
Citalopram (Celexa)
10
20
40
0
0
1+
1+
1+
1+
2+
3+
Watch for QTc prolongation if >40 mg daily. Max dose of 20 mg in patients over 65

Escitalopram (Cipralex)
5
10
20 (30**)
0
0
1+
1+
1+
1+
2+
3+
S-isomner of Citalopram
Max. dose of 10 mg in patients over 65

Fluoxetine (Prozac)
10
20
60
0
0
2+
1+
1+
1+
1+
3+
Long half-life useful for teenagers; however, caution in elderly
Watch for drug-drug interactions

Fluvoxamine (Luvox)
50
100
300
0
1+
1+
1+
0 to 1+
2+
1+
3+
Significant GI side effects
Dosages up to 150 mg can be given at night. Divide dose above 150 mg
Watch for drug-drug interactions

Paroxetine (Paxil)
10
20
50
1+
1+
1+
2+
0 to 1+
1+
2+
4+
Short half-life; watch for discontinuation syndrome
Avoid in elderly and pregnancy
Watch for drug-drug interactions

Sertraline (Zoloft)
25
50
200
0
1+
2+
1+
0 to 1+
2+
1+
3+
May be used in panic disorder; consider in postpartum

Vilazadone
(Viibryd)
10204001+1+00 to 1+3+1+0 to 1+Should be taken with food.  
Minimal sexual side effects.  
Significant nausea so titrate slowly.  Second line treatment for depression

Vortioxetine (Trintellix)
5
10
20
0
0
00
0
2+
0
0 to 3+
Sexual side effects are dose dependent
Crossover when switching
SNRIDesvenlafaxine (Pristiq)
50
50
100***
0
1+
2+
0
0
1+
0
1+May increase blood pressure! Watch for discontinuation syndrome

Duloxetine (Cymbalta)
30
60
120***
0
0
2+
0
0
2+
2+3+
Also approved for several pain conditions

Levomilnacipran (Fetzima)2040120002+1+02+03+Avoid in those with uncontrolled BP or HR, CHF  or recent MI Reduce dose in renal failure
Palpitations and nausea common

Venlafaxine XR (Effexor)
37.5
75
225 (300**)
0
1+
2+
0
1+
1+
1+3+
May increase blood pressure!
Short half life
Watch for discontinuation syndrome
NDRI
Bupropion XL (Welbutrin)
150
300
300 (450**)
0
0
2+
0
1+
1+
0
0
Avoid in those prone to seizures and in eating disorder
NaSSA
Mirtazapine (Remeron)
30
(at night)
30
45
1+
4+
0
0
1+
0
4+
1+
Significant sedation and increased appetite.


* Based on the recommendations found in the Compendium of Pharmaceuticals and Specialties (CPS)

** Consider exceeding recommended maximum dosage in special circumstances with input from psychiatry when possible

*** CPS states that no evidence of benefit above dose of desvenlafaxine 50 mg and duloxetine 60 mg


To obtain costs of these medications in Canada and whether they are covered by your provincial formulary please download the Prescribe Smart App found at https://prescribesmart.com/

Mental Health Algorithms © 2025 Copyright. All Rights Reserved. Web Policy Site Map Admin Login

Instructional Video

Medications Video

Email this page:

Instructions:
  • Email this page to your colleague or client.
  • Select the first option to send the entire page or select specific links and PDFs from this page to include in your email.
  • Click 'Send Email' below when ready.
Cancel
The from address of the sent email is: do-not-reply@mentalhealthalgorithms.ca.
The transmission of the email is secured with 256-bit SSL encryption.