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Which Do You Feel Is the Best Antidepressant?

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Updated September 01, 2011

Question: Which Do You Feel Is the Best Antidepressant?
Answer: It is difficult to say which is the best antidepressant because each person is different. No one antidepressant is going to be the best answer for every person. I've seen statistics saying that any given antidepressant will only help anywhere from 60-70% of people. The SSRI's (selective serotonin reuptake inhibitors -e.g. Prozac, Zoloft, Luvox, Paxil, Celexa) are often the first medication given because they work for a large percentage of people and have fewer troublesome side-effects than the older medications. It seems that the tendency to prescribe SSRI's first is changing, however. I just read a study which indicated that a newer medication called Effexor (venlafaxine) is about 10% more effective in achieving complete remission of symptoms. The reason being is that it affects two neurotransmitters (both serotonin and norepinephrine) rather than just one. More and more I think doctors are opting for the newer medications with novel modes of action as first line treatments. Either because they can affect brain chemistry in newer, more effective ways, or because they do not have some of the same side-effects. The SSRI's have certain side-effects which many people find intolerable, one of these being sexual dysfunction. Certain newer meds, like Wellbutrin (bupropion), do not cause this side-effect to any large extent.
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