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What’s the Best Antidepressant for You?

How will my doctor or psychiatrist decide which of types of antidepressant is best for me? The answer lies in some of the questions below.



1. What are your symptoms?


Your doctor will ask you what your exact symptoms are, to help him or her figure out which of the antidepressants will work for you. For instance, if you have trouble sleeping, your best bet will be to use an antidepressant that has a sedative effect, such as one you take at night. If you also have prominent anxiety symptoms, your doctor will likely prescribe one of the SSRIs such as sertraline or fluoxetine because of the research and present day recommendations around their use in anxiety.


2. Side Effects


Antidepressants have different side effects. For instance, SSRIs cause poor sleep, dry mouth, and sexual dysfunction while the Tricyclic Antidepressants are not closely associated with sexual issues. So discuss these side effects with your doctor to see which drugs you can tolerate.



3. Pregnancy and Lactation


Pregnancy and breastfeeding also influence which antidepressants will be best for you. You and your doctor will consider the benefits of each medicine vis-à-vis the risks of birth defects in a pregnant woman and childhood illnesses for breastfeeding mothers.

Each medication comes with their own risk which is which is why it is imperative you discuss these with your doctor. The SSRI Paroxetine should be avoided during pregnancy because of the risk of fetal heart defect. Also, MAOIs are generally discouraged in pregnancy because of the potential to limit the growth of the baby.

4. Other Health Conditions


Your doctor will factor in any other medical condition you have to choose the best antidepressant for you. If you have chronic pain, some pain specialists and other doctors might suggest certain medications from certain classes as there is some evidence around their use in pain. There are certain Tricyclic antidepressants and SNRI medications which tend to be used in chronic pain. We know there is a significant overlap between chronic pain and depression.

5. Family History of Use of an Antidepressant


If a first-degree relative, such as a parent or sibling, have used a type of antidepressant in the past and it worked for them, it may be a sign that the same type will work for you. Although this is not cast in stone, some psychiatrists and doctors consider response in family when prescribing.


6. What antidepressants you have tried before


Your doctor will likely ask you about previous antidepressants you have tried, your response and side effects to them. If you have had a good response to a particular medication, they may suggest you go back on it, or an antidepressant that is similar.


7. Drug Interactions


This is an important factor to consider when selecting the right antidepressant for you. Drug interactions with antidepressants can be severe, with many life-threatening complications. So you want to be sure you are not getting the wrong drug. For example, using an SSRI with the antibiotic Linezolid or pain medication tramadol has the potential to release a lethal serotonin surge that will send the body into an overdrive.


Antidepressants can take your depressive symptoms away within a few months, but it is imperative to choose the right drug for this to happen. Choosing the wrong drug could expose you to several side effects and drug interactions that may lead to worsening of symptoms, physical health problems and can event result in death. Work with your doctor and psychiatrist to determine which antidepressant is best suited to you.

Contact

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​E: support@epsychiatry.com.au

This is not an emergency service. Same day consults are not available. If you are in distress please contact your nearest emergency department, your local area mental health service triage or dial "000".  

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