Our expert says:
The effects are not entirely predictable, Ican, as there are considerable differences between each of us in how we handle every drug, and presumably in some of the fine details of our body and brain chemstry. Both sertraline and Cilift work in broadly similar ways, both can have useful benefits in anxiety ( but not in everyone ), both can producing a nuisance degree of weight gain in some people ( but not all ) ; and both are similarly effective in treating depression. There side-effects are broadly similar, too.
Earlier studies suggested that with pretty well any antidepressant, around 70 % of people ( with depression / MDD ) might be expected to respond favourably to its use. Because the early trials of any drug carefully select and refine the people it is tested upon, these results don't often match those when any drug is used in ordinary general practice, and more recent figures I've seen, suggest the likely proportion of people likely to get good results from any one random AD is probably 30 to 40 %.
Its not so far practical to predict who will respond best to which drug. That's very annoying, of course. The reality is that one of these drugs may be very helpful to you,and the other might be of no real use - or equally helpful. The only way to be sure is a proper trial at proper doses for a suitable length of time. Taking too little, or not for long enough, means any drug would be unsuccessful.
Another usually overlooked factor is compliance - a remarkably high proportion of people on any drug don't take it properly, at the right dose or timing, or at all, and of course they can't benefit from it either.
I am interested in the first genuinely new AD to arrive, Agomelatine, which works on a different chemical system to the usual ADs, seems equally effective for anxiety and depression, and doesn't have the weight-gain, nausea or sexual side-effects of most of the others.
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