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 Drugs in a relatively new family of antidepressants are all equally effective, according to a new study from the U.S. Agency for Healthcare Research and Quality. Which one you choose to take can therefore depend upon its cost, and which one has fewest side effects and is most effective for you as an individual.

Dr. Gerald Gartlehner and his colleagues analyzed data from 234 previously published studies concerning selective serotonin reuptake inhibitors (SSRIs), norepinephrine reuptake inhibitors (SNRIs) and other so-called "second generation" antidepressants. These drugs were developed in the 1960s, and became controversial in 2004 when they were linked to increases in suicidal ideation in adolescents prescribed them. SSRIs are frequently used for clinical depression, anxiety disorders, post-traumatic stress disorder, eating disorders, chronic pain, and obsessive-compulsive disorder. Some of their common trademark names are Prozac, Zoloft, Paxil, Celexa, Seronil, and Luvox. SNRIs include Effexor and Serzone; Wellbutrin and Remeron are chemically similar antidepressants. Side effects are most often sexual dysfunction, nausea, nervousness, insomnia, agitation, and decreased sweating with increased body temperature.

The researchers found no difference in how effective the drugs were, but there were distinctions in how quickly they took effect, their side effects, and their effect on a patient’s quality of life. For example, Remeron worked faster than Prozac, Zoloft, Paxil, or Celexa, and Wellbutrin had fewer sexual side effects than Prozac, Zoloft or Paxil.

"They are all equally effective," said Dr. David Schlager, a professor of psychiatry at Texas A&M Health Science Center College of Medicine. "If the patient has insomnia, you would pick something more immediately sedating. If the patient has weight loss or decreased appetite, you would pick something more likely to cause weight gain."

Besides, factors such as cost and side effects, a doctor might also consider the dosage. Patients are more likely to comply with their doctor’s recommendations if they have to take a drug less frequently.


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