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Side effects: Nausea, insomnia, headaches, sexual dysfunction, jitteriness; possibly drowsiness, dry mouth, constipation.It’s the worst one for weight gain, and among the worst for withdrawal symptoms (unless properly managed).Other common side effects: headache, dry mouth, constipation, sweating, dizziness, sexual dysfunction.Whom it may be suitable for: Depression sufferers with fatigue-like symptoms (norepinephrine works on the adrenal system); also a good option when SSRIs don’t work; not ideal for patients with hypertension.

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Most work equally well to relieve depression, so choosing the right one generally involves subtle differences.Slower-onset, longer-acting benzodiazepines are preferred. All patients should be encouraged to try cognitive behavior therapy.Augmentation therapy should be considered in patients who do not have a complete response.The strategy behind rational drug development is to design a new drug that is capable of affecting a specific neural site of action (eg, uptake pumps, receptors) while avoiding effects on other site of actions.The goal in such development is to produce agents that are more efficacious, safer and better tolerated than older medications. Although all SSRI drugs have the same mechanism of action, each SSRI has slightly different pharmacological and pharmacokinetic characteristics.

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