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problems related to obesity, a medication that helps with weight loss, or which is weight-neutral should be chosen. Patients who are experiencing extreme anxiety or even psychosis, may be treated with an antidepressant along with a second medication to more rapidly calm the agitation.

Making an accurate diagnosis is essential in choosing a medication for depression, as other disorders, such as bipolar disorder, may become worse if treated solely with antidepressants. Personality disorders, which may have depression-like symptoms associated with them, typically don't respond to medications. The patient should be assessed for suicidality as well. Sometimes a suicidal patient is so paralyzed by their depression they don't act on their urges until an antidepressant medication starts to work.

Obtaining a careful family history is also a factor in choosing a medication. If the patient has an immediate blood relative, like a parent or sibling, who has had a good response to a particular antidepressant, the patient is more likely to respond to that medication as well.

Medical problems, other medications being taken, and diet are also factors to be considered. Some medications for blood pressure, birth control, inflammation, pain, and other problems, can aggravate depression. The psychiatrist may request the patient to see their family doctor to consider different medications for those problems. Some foods can interact with certain antidepressants, especially the MAOIs, and a diet high in those foods might prevent the use of these medications for depression.

Antidepressants are not one size fits all. What works for one person may be a terrible choice for the next. Tailoring the choice of medication to each particular patient and their particular circumstances, is an important part of treating depression.

Learn more about this author, Harriet Squier.
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