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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
Mental Health Algorithms
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