How Do You Decide Which Type of Antidepressant to Prescribe?

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[MUSIC] That's again is a difficult question because of fear, we don't have tests to decide it, so one of the things I would do is to say for example somebody has previously been on medication that helped them and little gain obvious choice, given the whole genetic component of depression.

I also believe that therapeutic component has a genetic agent to it a family member has been helped with a certain drug, help them and I would go with that. In the absence of that, I would go with one that really has a good therapeutic benefits but very few side effect to start off with them and my personal opinion, the medication that typically go off with what is called SNR so 20 neurons can be re-updated because they look the most tonal in their friends.

As opposed to all SSR a lot of the SNR also have lesser side effects. So some of them so speaking of resistance of treatment. one of the big problems are with this medication so with SSR I wish you can use it to cross those factors all up almost all of them have a small risk of weight gain side effects.

Some of the SNRIs like desvenlafaxineand duloxetine have a much lower risk of this, so they're more those medication then you have to do sort of dual sort of connecting approach that will tolerate this so I will usually start with those and then move on to something else. There are certain flavors of depression that could tell you what you want to do, so to give an example if you have especially if you are an older patient, when Floyd prescribed the pressure he's seemed to enjoy decreased sleep and increased appetite , majority of the patients we see actually have the opposite, they have depression with typical features such as increased sleep and decreased appetite.

But the classic depression, so if someone came with decreased sleep and increase in appetite I might go with the medication from modacity which will make you tired,but it will help with the sleep does help build the appetite and it also works as an SNRI. It is not just testing, it is looking at the history, looking at the type of depression, the flavors that we have and then going with something but when I have none of that, then I will go with the one that is on the list of side effects which I know has the best potency.