Help Your Doctor Prescribe Your Ideal Antidepressant

Antidepressant treatment is an inexact science, so make it collaborative.
Your doctor needs to consider your current physical symptoms and condition when prescribing an antidepressant or mood stabilizer. If you have chronic insomnia, for example, she should obviously steer clear of the medications that list this side effect.

Medications you're already taking can influence your doctor's decision: SSRIs (selective serotonin-reuptake inhibitors) can interact with antihistamines, for example, triggering a racing heart and other potentially dangerous symptoms.

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How doctors prescribe antidepressants
"If a person asks for a specific antidepressant, I will often prescribe that one, unless there's a clear reason not to," says John Herman, MD, a psychiatrist at Massachusetts General Hospital and associate professor at Harvard Medical School, who says that this is one way to put a patient at ease. "If we can, we'll go with something that they're already familiar with, or that a friend is taking."

Maurizio Fava, MD, professor of psychiatry at Harvard Medical School, asks whether people have a history of prior treatment with a particular drug, because if it worked in the past, it might work again.

Depression may have a genetic basis, at least in some people. So if a patient tells Dr. Fava that a certain SSRI or atypical antidepressant worked in a parent or sibling, he may prescribe that one first.

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Last Updated: May 12, 2008

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