Antidepressants are a class of medications used primarily in the treatment of mood disorders (e.g. - major depressive disorder) and anxiety disorders. Its use has expanded to neurodegenerative and neuropsychiatric disorders in recent years.
Escitalopram | Low side effect profile, good for treatment with comorbid medical illness.[14] Commonly prescribed in primary care settings. Unfortunately it has a narrow dose range (maximum 20mg), due to increased risk of QTc prolongation at higher doses. This means you can only increase the dose so much before needing to switch to another antidepressant if there is no response. |
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Sertraline | Good for patients with comorbid psychiatric diagnoses. Indicated as a first-line medication for not just depression, but also generalized anxiety, obsessive compulsive disorder, posttraumatic stress disorder, social anxiety disorder and other disorder. Sometimes felt by clinicians to be more sedating than other SSRIs, but the research evidence does not necessarily demonstrate this.[15] Sertraline has a higher incidence of GI side effects which can be mitigated by taking it with food, and with HS dosing, but this can be a reason for discontinuation. |
Fluoxetine | Another good first-line choice and very similar to sertraline, with less GI side effects. It has the added benefit of also treating any comorbid eating disorders. It also has a long half-life, which means very little chance of withdrawal symptoms even if it is discontinued abruptly. |
In the elderly, falls can also be common with the use of SNRIs, TCAs, but less commonly in SSRIs.[19]