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Choice of antidepressant is also based on individual patient factors.
If a patient has responded well to an antidepressant in the past then that drug should be considered first choice. epilepsy, cardiovascular disease and bipolar disorder will also influence choice.
They should only be initiated by psychiatrists familiar with their use.
Moclobemide may be useful, particularly in patients who are intolerant of the adverse effects of other antidepressants.
Regular symptom review and monitoring of suicide risk are essential adjuncts to drug treatment.
It is usual to take SSRIs in the morning due to the risk of insomnia and TCAs at night because they may be sedative.The NICE British National Formulary (BNF) sites is only available to users in the UK, Crown Dependencies and British Overseas Territories.If you believe you are seeing this page in error please contact us.Treatment resistant cases should be referred to secondary care.SSRIs are better tolerated and are safer in overdose than other classes of antidepressants.
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Starting dose can be 10 mg of citalopram, fluoxetine or paroxetine.