by Harriet Squier

Created on: February 13, 2009

Depression is a mood disorder characterized by a lack of enjoyment in usual activities, changes in appetite and sleep, sadness, loss of concentration, fatigue, and other symptoms. Many people with mild to moderate depression can be successfully treated with psychotherapy and other non medical interventions such as bright light; exercise; relaxation techniques; eliminating the use of substances like recreational drugs, alcohol and caffeine; getting regular sleep; eating a balanced diet; and stress reduction. But when these interventions have been tried and failed, or when one's depression is severe enough to interfere with their ability to function in their work, relationships, and self-care, doctors will recommend antidepressant medications as well.

There are several different classes of antidepressants to choose from, including older medications called monoamine oxidase inhibitors (MAOIs) and tricyclics; selective serotonin reuptake inhibitors (SSRIs); norepinephrine and serotonin reuptake inhibitors; and others. Despite the differences in these medications' effects on neurotransmitters, chemical properties, side effects, and pharmaceutical company advertising, they all are EQUALLY EFFECTIVE in treating depression. The choice between them, therefore, is made on the basis of other factors.

When deciding which antidepressants may be best for a given patient, a doctor should take into consideration several factors. The first is the patient's history. If a patient has had a good result in the past from a particular antidepressant, they are likely to have a good result again. If they had a bad reaction or no improvement with an antidepressant in the past, that medication probably will be no more effective this time around. However, if a patient did not respond to one medication in a class of antidepressants, they may get better with a different medication from the same class. If the patient has depression symptoms despite already being on a medication, the doctor may instruct the patient to taper off that pill before, or while, starting on a new one.

Current symptoms are also important in making a decision about treatment. If the patient is having trouble sleeping, a sedating antidepressant may be useful. If they are sleeping all the time, a stimulating one may be useful. If the patient is not eating and has been losing weight, a medication that stimulates the appetite may be suggested. If the patient is overeating or is overweight, especially if they have medical

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