Antidepressant efficacy and side effect burden: an updated guide for clinicians

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Abstract

Antidepressant treatment has been evolving and changing since the 1950s following the discovery of the classic antidepressant treatments including tricyclic antidepressants and monoamine oxidase inhibitors. The heterogeneity of the disorder became apparent in the beginning when individuals remained symptomatic despite medication compliance. This spurred further research in order to understand the neurobiology underlying the disorder. Subsequently, newer medications were designed to target specific neurotransmitters and areas of the brain involved in symptom development and maintenance. Our original review article looked at both classic and modern antidepressant medications used in the treatment of major depressive disorder. This manuscript is an update to the original review and serves to provide clinicians with information about novel antidepressant medications, augmentation strategies with atypical antipsychotics, over-the-counter medications, as well as nonpharmaceutical treatments that should be considered when treating each individual patient who remains symptomatic despite treatment efforts.

Keywords: antidepressants, antipsychotics, depression, major depressive disorder, neuromodulator, postpartum depression, therapeutic, treatment-resistant depression.

Citation: Kutzer T, Dick M, Scudamore T, Wiener M, Schwartz T. Antidepressant efficacy and side effect burden: an updated guide for clinicians. Drugs in Context 2020; 9: 2020-2-2. DOI: 10.7573/dic.2020-2-2

Contributions: Thomas Schwartz conceived the idea, supervised the preparation, provided editing, and co-wrote the manuscript with Michelle Dick, Tatum Kutzer, Trevor Scudamore, and Mark Wiener, who provided substantial contributions to the literature review and editing. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at https://www.drugsincontext.com/wp-content/uploads/2020/04/dic.2020-2-2-COI.pdf

Acknowledgements: None.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2020 Kutzer T, Dick M, Scudamore T, Wiener M, Schwartz T. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2020 Kutzer T, Dick M, Scudamore T, Wiener M, Schwartz T. https://doi.org/10.7573/dic.2020-2-2. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/antidepressant-efficacy-and-side-effect-burden:-an-updated-guide-for-clinicians

Correspondence: Thomas Schwartz, Department of Psychiatry, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA. SchwartT@upstate.edu

Provenance: invited; externally peer reviewed.

Submitted: 18 February 2020; Peer review comments to author: 11 March 2020; Revised manuscript received: 16 April 2020; Accepted: 20 April 2020; Publication date: 26 May 2020.

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