Which Antidepressant Is the Best?

October 30, 2020

Depression can be quite challenging to treat. Treatment should consist of cognitive behavioral therapy (counseling) and in more severe cases where counseling does not adequately treat it, antidepressant medications are warranted. But what is the best antidepressant for you?

That might take some time and effort to discover. Every person is different, and everyone responds to medications differently. Not all antidepressant medications work the same (mechanism of action), so you—in conjunction with your doctor—might have to ship around for the one that will do the most good.


Types of Antidepressants

Selective serotonin reuptake inhibitors (SSRIs)–work by increasing the level of a molecule known as serotonin, between cells in the brain. Serotonin is a neurotransmitter, a molecule that helps brain cells to communicate, and low levels are associated with depression. SSRIs are often the first drugs prescribed for depression (first-line antidepressants). Examples of SSRIs are:

  • Prozac (fluoxetine)
  • Zoloft (sertraline HCl)
  • Cipramil (citalopram)
  • Priligy (dapoxetine)
  • Cipralex (escitalopram)
  • Faverin (fluvoxamine)
  • Seroxat (paroxetine)
  • Lustral (sertraline)
  • Brintellix (vortioxetine)

Serotonin Norepinephrine Reuptake Inhibitors–are prescribed when SSRIs alone are not enough. Norepinephrine is another neurotransmitter. The list includes:

  • Effexor (venlafaxine)
  • Cymbalta (duloxetine)
  • Pristiq (desvenlafaxine)

Atypical antidepressants–increase levels of dopamine as well as serotonin and norepinephrine in the brain. The following are examples:

  • Wellbutrin (bupropion)
  • Desyrel (trazodone)
  • Remeron (mirtazapine)

Tricyclic antidepressants–increase levels of serotonin and norepinephrine as well as blocking levels of another neurotransmitter, acetylcholine, in the brain. The following are tricyclic antidepressants:

  • Norpramin (desipramine)
  • Tofranil (imipramine)
  • Pamelor (nortriptyline)


Unfortunately, there is no simple test to tell which medication will be most effective for any individual patient. What complicates the issue further is that most antidepressants take at least a few weeks to start showing an effect on someone’s mood. A helpful way to more objectively decide if a therapy is effective is start a ‘mood journal’, which is a diary in which you write down every day how you feel. You could even create a mood scale, e.g. between 1-10, to observe how and if things are changing over time. Remember, depression is a not an in-the-moment feeling, it is an abnormally depressed mood over some time.

Some degree of trial and error is frequently necessary before you find the best anti-depressant for you. Once you find the right medication, life can be considerably brighter.

Did you know that QuickMD can prescribe you anti-depressants online, from the convenient of your home? No insurance is needed.

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