You will find that most, (responsible Psychiatrist) will almost always start a depressed paitent that has never taken an antidepressant medication before, on an SSRI first.
Much the same way as most Psychiatrists will not start a new patient on a Tri-cyclic or Tetra-cyclic antidepressant.
This is mainly due to the fact that SNRI medication such as Cymbalta and Effexor have a much higher occurance of side effects and also because the Withdrawl (withdrawal) from the discontinuation of SNRI medication is proven to be more severe than that of SSRI medications.
Also by starting a patient with an SSRI, if that patient does not respond to the treatment, then he has a back up plan and can then try an SNRI.
This has been my experience by observing the ways Psychiatrist prefer to dispense medication to newly diagnosed sufferers.
I've suffered from agorophobia for 31 yrs., and have run the roller coaster of benzos and anti-depressants for that entire time. I really didn't want to go on Valium at the ripe old age of 25, but I tried to conquer the agorophobia on my own, and just couldn't do it. I had a 4 yr old, and a new baby, so I had to be functional (my ex travelled). They switched me to Xanax, which didn't work, and my current drug is klonopin for the past 25 years. I've yet to find an honest Dr. over the course of this journey, and trust me, I've gone to a lot of them. #1, none of them admit klonopin is addictive or has side effects (????), and trust me, I asked! When I'd refer to the list of side effects, warnings, etc, they just say that those are "rare", and if one person out of a million has a reaction, they have to list it. About 3 yrs. ago, the panic attacks came back with a vengeance, and brought along severe depression. I've been on disability for 2 yrs., and I'm so frustrated. They've tried me on many anti-depressants over the years, too, and they have all made me extremely hostile. I'm trying to wean myself slowly off of the klonopin, as I'm worse now than I was 31 yrs. ago when this all started. I think it should be part of a Drs. residency to be put on some of these drugs for about a year, and then take them off of them cold turkey. I wonder how many of them would still say the drugs are non-addictive, and the side effects rare??? I had admitted myself to our local mental health hospital 2 yrs. ago when the depression got so bad, and I asked if such long term use of klonopin could be causing the problem. They all said "no", wanted to up the dose, and add Lexapro to the mix. I know there are good Drs. out there, but you would think I'd have hit on a good one over the years. Sorry, guess where I was going with that is that anti-depressants also make me angry to the point that I scare myself, so I stay away from those!
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