Treating depression in primarycare: The latest guidelines
American College of Physicians clinical guideline on the treatment of depression
Treatment can have no effect, a partial effect, or a full effect leading to remission. Because the majority of people started on treatment don't achieve full remission, it's important to be comfortable with second-line treatments for those who don't fully respond. There are some notable differences among the different medicines. The SSRIs often lead to a loss of appetite, sexual dysfunction, and insomnia. Mirtazapine, unlike the SSRIs, can lead to weight gain instead of weight loss and can be sedating, so it's useful for patients who have trouble sleeping at night. Bupropion and mirtazapine are not associated with sexual dysfunction.
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