First line ssri for depression

They found that agomelatine , amitriptyline , escitalopram , mirtazapine , paroxetine , venlafaxine , and vortioxetine were more effective than other antidepressants. They also found agomelatine, citalopram, escitalopram, fluoxetine. Latendresse G , Elmore C, Deneris A. This review examines the antidepressants that are currently used as the initial or first-line therapies for major depressive disorder ( MDD ). These newer medications may be grouped into three classes: the selective serotonin reuptake inhibitors , the serotonin and norepinephrine reuptake inhibitors , and the norepinephrine-dopamine reuptake inhibitor.

Depression is a complex mental illness that can result in significant disability, reduced quality of life, and societal burden. Pharmacological agents are one of several initial treatment modalities used for depression and one of the most frequently utilized classes of drugs are the selective serotonin reuptake inhibitors ( SSRI ). SNRIs , which include venlafaxine ( Effexor ), desvenlafaxine ( Pristiq ), duloxetine ( Cymbalta ), and levomilnacipran ( Fetzima ) can be used as first-line agents, particularly in patients with significant fatigue or pain syndromes associated with the episode of depression. Prozac ( Fluoxetine ): This SSRI is mostly prescribed for major depression, but also is used for certain types of anxiety such as: OCD , PTSD , and panic disorder.

Although it may reduce anxiety among certain individuals, it is not considered a first-line antidepressant option for anxiety disorders. Similarly, if drug treatment is indicated for GAD , and an adult chooses to take medication, the NICE guideline on GAD in adults recommends offering an SSRI with sertraline as the first‑line option because it is the most cost‑effective drug for this condition. Selecting an antidepressant — For people with mild to moderate depression who start treatment with an antidepressant , we suggest SSRIs.

Among the different antidepressants , SSRIs offer as much benefit as other medications with the least amount of risk in terms of safety and side effects. SNRIs, which include venlafaxine (Effexor), desvenlafaxine (Pristiq), duloxetine (Cymbalta), and levomilnacipran (Fetzima) can be used as first - line agents, particularly in patients with significant fatigue or pain syndromes associated with the episode of depression. Cognitive Behavioral Therapy: A First - line Treatment for Depression.

Based on identifying maladaptive patterns of thought and behavior and implementing strategies for change, CBT is a short-term, evidence-based approach. SSRIs are the most commonly prescribed class of antidepressants. An imbalance of serotonin may play a role in depression. These drugs fight depression symptoms by decreasing serotonin reuptake in your brain.

This effect leaves more serotonin available to work in your brain. It should be mentioned that SSRI antidepressants are a great first - line treatment option for people with anxiety and comorbid depression and individuals with depression and comorbid anxiety. Although most doctors will simply throw SSRIs at you if you mention anxiety and depression , they may tweak treatments based on whether you are experiencing more anxiety than depression or vice versa. TCAs block the reuptake of both the serotonin and norepinephrine neurotransmitters to exert their antidepressant effect.

Approximately 15–percent of adults older than age in the United States have experienced depression. Multiple systematic reviews have shown that antidepressant medications are better than placebo for treating depression in older patients. However, effects are modest and side effects are common.

Other pharmacotherapies are reserved for situations where first-line antidepressants are not indicated or cannot be use or when first-line treatments have not worked.

A selective serotonin reuptake inhibitor ( SSRI ) is usually the first - line pharmacological treatment for patients with moderate to severe depression who have not responded sufficiently to non-pharmacological interventions. Given the side effect profile and high rates of drug-drug interactions, monoamine oxidase inhibitors (MAOIs) are not considered first - or even second- line agents for depression in the elderly. First - line antidepressant therapy with SSRIs or TCAs is effective in relieving depression in to of geriatric patients.

For patients who are unresponsive or intolerant to this first - line therapy, bupropion, venlafaxine, or an MAO inhibitor can be tried alone or, alternatively,. Selective serotonin reuptake inhibitors ( SSRIs) are antidepressants that affect serotonin levels in the brain. Following an extensive systematic review of treatments for major depression , the American College of Physicians (ACP) issued a recommendation to clinicians suggesting cognitive behavioral therapy (CBT) as a first - line treatment for major depressive disorder along with second-generation antidepressants. Serotonin is a chemical neurotransmitter.

Major depressive disorder affects million Americans, and treatment is difficult. We often find ourselves in a position to re-evaluate a patient, treated with a first - line antidepressant, who has not achieved remission. The purpose of this article is to assist providers to select the safest, most effective selective serotonin reuptake inhibitor (SSRI) as the first‐line antidepressant during pregnancy and lactation. Information about side effects, adverse effects, contraindications, and clinical considerations associated with the use of SSRIs is provided. These medications are considered as effective as SSRIs, so they are also considered a first-line treatment for the treatment of anxiety disorders, but not for obsessive compulsive disorder ,where SSRI’s are the preferred first line treatment.

In patients with unstable angina or who have had a recent myocardial infarction, sertraline has been shown to be safe. Electroconvulsive therapy (ECT) is recommended as a first - line treatment for psychotic depression in the elderly, with a recovery rate of over and a faster and fuller response compared to medication. Choosing an antidepressant — For the initial treatment of severe depression, we use serotonin-norepinephrine reuptake inhibitors (SNRIs) or selective serotonin reuptake inhibitors (SSRIs).

In people who have symptoms of psychosis (hallucinations, delusions), starting with an antidepressant and antipsychotic medication may be appropriate.