NICHE

When choosing an antidepressants knowing and utilizing the drugs special areas of effectiveness “NICHE” and it’s unique ADVANTAGES along with it’s side effect profile assist in choosing.  This chart and narrative explain a few of them.  
 

DRUG

"NICHE"

ADVANTAGES

SSRI's -Effective in most depressions.
-Safe in cardiac conduction problems, glaucoma & BPH
Low amount of anticholinergic side effects
Mirtazapine
(Remeron)
-Insomnia, anorexia + weight gain, sleep
Bupropion
(Wellbutrin)
-Effective for lethargy & apathy or history of mania. If poor response to other classes & in cardiac dz. -Stimulating
-Smoking cessation

 

Psycho-stimulants
(Methylphenidate)
-Effective in apathy in medically ill with depressed mood.
-Can combine with other antidepressants short term
-Rapid onset
-Low risk addiction
-Minimal side effects
 
Venlafaxine
(Effexor)
-Severe depression, assoc. with generalized anxiety, neuropathic pain or if poor response to other treatments -Efficacious for severe depression
 
Duloxetine (Cymbalta) -Diabetic neuropathy