Choosing an Antidepressant

• Has the patient responded to a particular antidepressant in the past?

  • Consider using that antidepressant

• Has there been a family history of response to a certain antidepressant?

  • Consider using that antidepressant
    
    

• Is the patient on multiple medications? Consider…

  • Citalopram (Celexa)
  • Escitalopram (Cipralex)
  • Venlafaxine (Effexor)
  • Desvenlafaxine (Pristiq)
  • Mirtazapine (Remeron)
    
    

• Is there chronic pain? Consider…

  • Duloxetine (Cymbalta)
  • Venlafaxine (Effexor)
    
    

• Is there cardiovascular illness? Consider…

  • Sertraline (Zoloft)
    
    

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

  • Mirtazapine (Remeron)
    
    

• Does the patient  want to minimize the risk of sexual side effects? Consider…

  • Bupropion (Wellbutrin)
  • Vilazadone (Viibryd)
  • Vortioxetine (Trintellix)-at doses of 10 mg and below
  • Mirtazapine (Remeron)
  • Desvenlafaxine (Pristiq)
    

• Is the patient a child/youth (age < 18)? Consider…

  • Fluoxetine (Prozac)
    
    

• Is the patient in the perinatal period? Consider…

  • Sertraline (Zoloft)
  • Escitalopram (Cipralex)
  • Citalopram (Celexa)
  • Fluvoxamine (Luvox)
  • For more information, visit MotherToBaby
    
    

• Is cost an issue? If so, then consider these less costly medications…

  • Citalopram (Celexa)
  • Escitalopram (Cipralex)
  • Sertraline (Zoloft)
  • Mirtazapine (Remeron)
  • Bupropion (Wellbutrin)
  • Venlafaxine (Effexor)
    • To obtain costs of  medications in Canada and whether they are covered by your provincial formulary please download the Prescribe Smart App found at https://prescribesmart.com/
      
      

• Patient preference

Otherwise, choose…

• Any SSRI or SNRI