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Augmentation with lithium or triiodothyronine may be useful in patients who are partially or totally resistant to antidepressant treatment.Finally, tapering anti-depressant medication may help to avoid discontinuation syndrome or antidepressant withdrawal.This article is an update of information about the newer agents for depression and new indications for older antidepressants.Selective serotonin reuptake inhibitors (SSRIs) have replaced tricyclic antidepressants as the drugs of choice in the treatment of depressive disorders, mainly because of their improved tolerability and safety if taken in overdose.According to a recent survey1 of the most common reasons for patient visits to family physicians in the United States, depression and anxiety ranked 11th and 17th, respectively.Ten to 20 percent of adults in the United States experience depression at some point in their lifetime.2 Many antidepressants have been released in the United States over the past two decades.
Administration usually begins with 20 mg per day, taken in the morning because of its potential for central nervous system activation early in the treatment course.The most common side effects of sertraline are nausea, dry mouth, fatigue, and decreased libido.Treatment with sertraline should be started at 50 mg, either daily throughout the month or daily during the luteal phase of the menstrual cycle. Extended-release venlafaxine has recently been approved by the U. Food and Drug Administration for the treatment of generalized anxiety disorder. New indications for selective serotonin reuptake inhibitors include post-traumatic stress disorder, premenstrual dysphoric disorder, and generalized anxiety disorder.