Medications

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