No abstract

The pharmacotherapy of depression has undergone significant change in the last two decades. A new generation of antidepressant agents has displaced older drugs as first-line therapies for depression. The clinician that seeks optimal outcomes for treatment of depression must be familiar with all of the available antidepressant agents. This article will discuss the pharmacologic profile of antidepressants currently marketed in the United States, identifying similarities and differences that have clinical relevance in the management of depression. Drug selection with an emphasis on antidepressant receptor affinity will be reviewed.

Recognizing and monitoring predictors of elevated or toxic TCA Cps, including increasing TCA dose, female gender, and concurrent use of fluoxetine or paroxetine, may reduce serious adverse drug reactions and deaths in the TCA-receiving patient population.