Article May 1, 1998

Selecting an Antidepressant by Using Mechanism of Action to Enhance Efficacy and Avoid Side Effects

Stephen M. Stahl, M.D., Ph.D.

J Clin Psychiatry 1998;59(suppl 18):23-29

Article Abstract

The diversity of antidepressant mechanisms available today allows clinicians to individualizetreatment decisions for depressive symptoms and subtypes, as well as to avoid side effects. The mechanismof action of antidepressants allows prediction of both adverse effects and therapeutic effects.Individual antidepressants have unique psychopharmacologic profiles, and individual patients haveunique clinical profiles of different symptoms and depressive subtypes. By using this knowledge, theprescriber can match drug profiles with patient profiles to select preferred agents and avoid lesspreferred agents.