How will my doctor or psychiatrist decide what is the best antidepressant for me? The answer lies in some of the questions below. We will also go over some other common questions. Such as, what is the strongest antidepressant? Plus, how long should you try an antidepressant before changing?
1. What are your symptoms?
Your doctor will ask you what your exact symptoms are, to help him or her figure out which 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 the 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
Certainly, this has different side effects. For instance, SSRIs cause poor sleep, dry mouth, and sexual dysfunction while Tricyclic Antidepressants are not closely associated with sexual issues. However, 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 its own risk which is why it is imperative you discuss these with your doctor. However, 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. 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 the response in the family when prescribing.
5. What antidepressants you have tried before
Certainly, your doctor will likely ask you about previous antidepressants you have tried, your response and their side effects. If you have had a good response to a particular medication, they may suggest you go back on it, or something that is similar. Remember, there is no such thing as the strongest antidepressant. Newer antidepressants do not always mean better.
6. Drug Interactions
This is an important factor to consider when selecting the right antidepressant for you. Drug interactions with antidepressants can be severe. They can cause 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 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 even result in death. However, work with your doctor and psychiatrist to determine what is the best antidepressant for you.
This usually takes 3 or 4 weeks to start having an effect. Being patient is important. If side effects are bad, your doctor will advise you to stop before 3 weeks. Is there such a thing as the strongest antidepressant? No. It’s about what works for you. Each of us is different. Speak with your doctor. It’s important to have an open dialogue. Follow their recommendations. Your GP can refer you to one of our psychiatrists at Epsychiatry. Our friendly support team can make an appointment for you.