Second-generation antidepressants, such as Prozac, Paxil, Zoloft and nine other medications, are equally effective, according to guidelines issued today by the American College of Physicians. Since the medications work equally well, doctors and patients should select an antidepressant based on its side effects -- which do vary among drugs -- cost and patient preference.
The newer antidepressants are often used in place of older antidepressants, such as tricyclic antidepressants, because they have fewer harsh side effects. The guidelines issued today reviewed more than 200 studies on the benefits and harms of 12 second-generation drugs: bupropion, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, mirtazapine, nefazodone, paroxetine, sertraline, trazadone and venlafaxine.
Side effects from these medications vary widely and can range from mild, such as constipation, to severe, such as suicidal thoughts. According to the paper, published in the Annals of Internal Medicine, patients should be assessed for adverse side effects within one to two weeks of starting therapy. The treatment should be changed if the patient does not have an adequate response by six to eight weeks of therapy. Treatment should continue for four to nine months after a satisfactory response in patients with a first episode of major depression.
-- Shari Roan
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