115 Antidepressant Medication Considerations (CoMorbid Neuro/Med and Psych Symptoms)
| Symptom(s): Depression + | Consider | Avoid |
| Anxiety | SNRI | None |
| OCD | Fluoxetine | TCA, Bupropion |
| Psychosis | SSRI, SNRI + Anti-psych | TCA, Bupropion |
| Somatization | Duloxetine | TCA |
| Abulia | Bupropion | TCA, Paroxetine |
| Delerium or Dementia | Citalopram | TCA, Bupropion |
| Fatigue | Bupropion, Fluoxetine | TCA, Paroxetine |
| Insomnia | Mirtazapine | TCA, Fluoxetine |
| Pain | Duloxetine, TCA | SSRI |
| Parkinsonism | Bupropion, Mirtazapine | Sertraline, Paroxetine |
| Seizures | SSRI, SNRI | Bupropion |
| Tremor | Mirtazapine | SSRI, SNRI |
| Stroke | Citalopram | TCA |
| Vertigo | Fluoxetine | TCA |
| Advanced Age | Citalopram, Bupropion | TCA |
| Constipation | Bupropion, SSRI, SNRI | TCA |
| Diarrhea | Mirtazapine, TCA | SSRI, Bupropion |
| DM | Bupropion, SSRI, SNRI | TCA, Paroxetine |
| Glaucoma | Bupropion, SSRI, SNRI | TCA |
| Heart Disease | SSRI | TCA, Mirtazapine |
| Hypotension | Bupropion, SNRI | TCA |
| Renal Failure | Fluoxetine | Bupropion |
| Hepatic Failure | Bupropion | Duloxetine, Citalopram |
| Nausea, GERD | None | Paroxetine, Sertraline |
| Overweight | Bupropion | TCA, Mirtazapine |
| Pregnancy | SSRI, SNRI | TCA |
| Sexual Dysfunction | Bupropion | Paroxetine, SSRI |
| Smoker | Bupropion | TCA |
| Urine Retention | Bupropion | TCA |
(SSRI,SNRI,Bupropion,Mirtazapine)
- no agent superior for associated pain, anxiety, insomnia
- higher incidence of side effects:
- Venlafaxine > nausea
- Sertraline > diarrhea
- Mirtazapine > weight gain
- Bupropion > less sexual dysfunction
- Mirtazapine > faster onset of action
