ANTIDEPRESSANTS AND FAMILY MEDICINE – HOW MANY DO WE NEED TO KNOW?

Introduction and Objective: Depression is common in primary care patients and, therefore, dealing with antidepressants has become usual in the familiar medicine activity. Patients with depression usually have a long list of comorbidities and somatic complaints and it is sometimes challenging to know whether a new sign or symptom has appeared, or if the patient is just having an adverse effect of one of his medications. Antidepressants are a fine example of this kind of drugs: they are safe, effective, but also responsible for side effects and drug-to-drug interactions that complicate clinical judgement. The aim of this work is to summarize the extensive list of available antidepressants and to create an instrument of quick reference to help choosing a specific drug for a specific patient. Methods: Review of the recent literature related to the pharmacological treatment of depression in primary care. Results and Conclusions: Given the lack of clear superiority among antidepressants, selecting a drug is based upon their pharmacological aspects, possible side effects and patient characteristics. For this purpose is preferable to focus our knowledge and experience on a few drugs, and to choose between them, than to try to encompass all the drugs available. SSRI’s are the first line choice since they are safe, well tolerated, have few pharmacological interactions, and have a low price. Nevertheless, since family doctors deal with their patients throughout their lives, they need to know some peculiarities related with specific periods of life or with associated diseases.