Antidepressants are the medicine of choice when treating depression, though they are not all the same. Each type of antidepressant acts on a different neurotransmitter, which affects how the patient's body reacts. The Mayo Clinic states that selective serotonin reuptake inhibitors (SSRIs) are often the first choice for antidepressants, though other factors are taken into consideration that may result in another antidepressant being prescribed.
Symptoms
When prescribing an antidepressant, the doctor will look at how effective the medication is in treating the patient's symptoms. If, for example, the patient does not respond to an SSRI, she may be given a dual reuptake inhibitor, like a norepinephrine and dopamine reuptake inhibitor (NDRI) or serotonin and norepinephrine reuptake inhibitor (SNRI). Older antidepressants, like monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants, are given when other antidepressants have not been effective for the patient.
Dietary Restrictions
Some antidepressants have dietary restrictions, which may be a deterrent for some patients. For example, patients who take MAOIs cannot eat foods that contain large amounts of tyramine, such as some cheeses and meats, pickled foods, chocolates and liquor. The Mayo Clinic states that the interaction of tyramine and an MAOI can increase the patient's blood pressure, which could lead to a stroke.
Possible Side Effects
Each antidepressant has side effects; while some of these side effects go away after the patient's body adapts to the medication, others may last longer and can interfere in the patient's life.
The Mayo Clinic lists sexual dysfunction as an effect that can occur with SSRI and NDRI use. For some patients, the side effects can be severe enough that the medication needs to be changed.
Drug Interactions
When prescribing an antidepressant, the doctor needs to take into consideration other medications the patient is taking because there could be drug interactions. For example, the Mayo Clinic states that patients who take tramadol, meperidine, over-the-counter decongestants, herbal weight-loss products or St. John's wort should not be given an MAOI for depression.
Treating Other Symptoms
While the main purpose of the antidepressant is to treat the symptoms of depression, some antidepressants treat other disorders. NDRIs, like bupropion, can also treat the symptoms of attention deficit hyperactivity disorder (ADHD), and help a patient quit smoking, according to the Mayo Clinic.
