How to Choose the Right SSRI

A selective serotonin reuptake inhibitor, or SSRI, is a type of antidepressant that increases the concentration of serotonin in the brain. Serotonin is a neurotransmitter in the central nervous system that influences sleep, appetite, memory, pain, secretion of hormones and mood. Boosting the serotonin concentration can alleviate depression in many cases. Many psychiatrists prefer SSRI antidepressants, which are newer, over older medicines because SSRIs have fewer side effects and are more difficult to abuse. There are several different SSRIs on the market, including fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), escitalopram (Lexapro) and citalopram (Celexa). Ultimately, your health-care provider must choose the SSRI she thinks will work for you, but you can take steps to help her make the right decision.

Instructions

• 1

  Consider your overall energy level. Is it usually low? Then you may need an SSRI that is stimulating rather than sedating. In contrast, if you are extremely active, an SSRI with a sedating effect may help you achieve a happy medium. Paxil appears to be the most sedating of the SSRIs, and Prozac appears to be the most activating.

• 2

  List the other medicines you are taking. Some SSRIs interfere with other agents, and vice versa. For example, Paxil limits the body's absorption of tamoxifen. Be sure your health-care provider is aware of all other agents you are using, including herbal remedies.

• 3

  Consider your medication history. Have you used an SSRI before? Which one? Was it effective? If so, it is likely to be effective again. If it didn't help, try a different agent.

• 4

  Talk to family members who have been treated for depression. Has a close relative used an SSRI? If so, her response to a particular SSRI is likely to be similar to your response. For example, if she found Zoloft to work best after trying several SSRIs, chances are Zoloft will work for you too.

• 5

  Check your insurance coverage and budget. If you don't want to pay a lot, an SSRI that is available in generic form will be cheaper. Except for Lexapro, all of the SSRIs are available as generics.

• 6

  Inventory your other symptoms. For example, do you experience a high level of anxiety or have frequent panic attacks? Are you suffering from post-traumatic stress disorder? Be sure to describe all your symptoms -- not just depression -- so your health-care provider can choose the SSRI that will come closest to alleviating all of them. In some cases, your health-care provider may prescribe more than one medicine.

• 7

  Be flexible and patient. Keep in mind that it can take as long as eight weeks for you to experience the full effects of a particular SSRI. If you are not feeling better after two months, your health-care provider may want to increase the dosage or switch you to a different agent. It sometimes takes several months before the right medicine and dosage are established for you.