General Principles that Psychiatrists follow in trying to pick the right antidepressant medication for you
In general if you have quite a lot of anxiety along with your depression psychiatrists will start treatment with an SSRI antidepressant. In this sense antidepressant is a misnomer as most antidepressants also treat anxiety. We now have 8 different SSRIs so there is a plethora of choices (Prozac, Paxil, Zoloft, Celexa, Lexapro, Luvox, Viibryd, Trintellix) . My first choice is usually Lexapro (escitalopram) for two main reasons. It is really well tolerated with up to 90% of patients tolerating it without difficulty. In addition dosing is very simple. The first dose used is 10 mg usually which right away is an effective dose. The maximum dose is 20 mg so just one step away if needed.
Lexapro is also approved by the FDA to treat generalized anxiety (GAD) and this is very helpful by virtue of the fact that up to half of those with major depression will also suffer from GAD so the two disorders can be treated with the one medication. Additional SRRIs her also include some older SSRIs such as Prozac, Zoloft, Celexa and Luvox as well as two more recent additions (Viibryd and Trintellix). More on these in the next post.