Very often I am asked to recommend what I think is the best antidepressant. My answer? The one that works for you. Each person is unique and may not respond to the same medication.
Each class of antidepressant works on your brain chemistry in a different way. Dr. Abbott Lee Granoff, an expert in the field of panic disorder and depression, says the following: "There are currently 23 antidepressants on the market. (Guide Note: This figure has increased since Dr. Granoff was interviewed for this article.) Each increases certain neurotransmitters in the brain and each can do this in slightly different parts of the brain." So, while one person may get relief from having their serotonin boosted, another may need a drug that affects both serotonin and norepinephrine. Still another person may need an entirely different sort of medication, such an anticonvulsant or a mood stabilizer like lithium. Further, a person who does well on a medication such as Zoloft may not do as well on Prozac, even though both belong to the same class.2 Each person will be very different in their medication needs.
Just like the wide variety of brains, there are a wide variety of antidepressants. Broadly speaking, these fall into the following classes: monoamine oxidase inhibitors (MAOIs), tricyclics (TCAs) and selective serotonin reuptake inhibitors (SSRIs). There are also several newer medications that are unique in their mechanism of action.