IF PROZAC IS AS GOOD AS EVERYONE SAYS IT IS, WHY DO DOCTORS STILL PRESCRIBE OTHER DRUGS FOR DEPRESSION?
Many physicians and psychopharmacologists feel comfortable with tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) because for over thirty-five years they have prescribed them with great success for millions of patients. It is true that these drugs have more side effects than Prozac and the other new SSRIs, but patients can often tolerate the side effects without undue complaints if educated in what to expect: dry mourn, constipation, sometimes a little dizziness, mild sexual difficulties. These side effects are annoying but not terrible, and by and large, these older antidepressants have worked well. Thus, many physicians are reluctant to prescribe a new drug, despite the miraculous claims that may accompany it. Faced with a depressed patient, cautious, conservative physicians and psychopharmacologists often turn to the old medications first, If the patient cannot tolerate the side effects or if the dosage, when escalated to the top, does not bring the patient out of the depression, then they may try one of the new SSRI antidepressants, Wellbutrin, or Effexor.
Despite the hesitation of so many conservative physicians, the number of psychiatrists using the old battery of ten to fifteen antidepressants has eroded every year since Prozac was launched.
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