How to select an antidepressant lecture

[@user-xy4ff5yp7b]

Awesome that St John’s Wort is in the guidelines. It helped my severe depression so much. Appreciated it as a young man that it did not cause any sexual dysfunction.

[@blilycat7020]

Would love to see you offer more case studies like this with rational super help full! Would pay top dollar!

[@dawiteden]

I have to say, this is the top video on SSRIs, the best!!! Thank you!! Pls post more on psych meds!! 🙏🙏🙏

[@DanGreer]

Thanks for the kind comment!

[@Sakaripeltola]

Really nice, calm, informative video. 👌🏻👌🏻👌🏻

[@DanGreer]

Thanks for the kind words

[@colin8770]

Really interesting presentation thanks for it! (Not that I'm a professional, this stuff is interesting in general to me) (Learned a lot about the different classes on antidepressants, which always stumped me when I read them on a wikipedia page or such, I guess it's cuz of the layout) Thanks again!

[@DanGreer]

Thanks Colin, I am glad you enjoyed it.

[@maureenina9203]

Great presentation, is it possible to get the PowerPoint pls ?

[@buildandrelax1495]

Technically you could add Acetaminophen on the list since it dulls emotions and reduces social pain. Its very good for social anxiety. But it is not on this list because it only costs a few cents and the WHO evaluates removing its over the counter status because a lot of people attempt suidide or accidentally overdose because they didnt read the manual.

[@Jermfrog]

very well done. thanks.

[@user-xy4ff5yp7b]

You have to consider discontinuation syndromes too. Fluoxetine is least likely to cause withdrawals.

[@johnnytran7187]

Hi Dan, at 29:00 your webcam cuts off the bottom right corner. What is the text that supposed to go there? Also do you mind sharing the PPT? Thank you

[@DanGreer]

Hi Johnny, it says more weight gain, and lists drugs that cause more weight gain like TCAs and mirtazapine

[@user-xy4ff5yp7b]

Could you make a video about the psychopharmacology of St John’s Wort? 😊

[@marilynmartin8617]

Excellent.

[@DanGreer]

Thanks Marilyn!

[@nickzee1637]

Thankyou, great information

[@DanGreer]

You're welcome, thanks for watching

[@Dr-789]

For depression and anxiety Is buspirone or SSRI like flouxetine/ecitilopram can be added to trazedone using in sleeping dose ??? Is buspirone is good for major depressive disorder and whats the dose.??...thanks

[@DanGreer]

Either buspirone or an SSRI can be added to trazodone. Buspirone is fine for MDD it is usually used as an adjunct to other medications. Usually total daily dosing range is 15-60 mg

[@lukeraynor3704]

Hi Dan, great video! In your experience what would be more activating/energizing between Bupropion and Duloxetine?

[@DanGreer]

Hi Luke, thank you. In my experience Bupropion is more energizing.

[@lukeraynor3704]

@@DanGreer thank you! Can you combine the two? Have you seen this done before?

[@DanGreer]

@@lukeraynor3704 Yes you can due to the differences in mechanism and yes I have

[@johnnytran7187]

Hi Dan. Can you augment mirtazapine/trazodone used for sleeping with Rozerem?

[@DanGreer]

Yes you can under a doctor's guidance

[@Dr-789]

Channel is subscribed .....Can u tell me Which is most tolerated , with least sexual dysfunction and also cover panic attack in SSRI group , SNRI ???

[@DanGreer]

My starting point is usually escitalopram in the SSRI group. It is generally considered relatively well tolerated and not too many drug interactions. Least sexual dysfunction is usually bupropion, mirtazapine doesn't have as much either

[@davelospinoso9022]

Great video, I'm surprised the pharma companies haven't spun out a bunch of Bupropion-like drugs... Wellbutrin has a Monopoly on the NDRI category

[@DanGreer]

Thanks Dave, I agree, they should try to make more in that class.

[@davelospinoso9022]

@@DanGreer what would you recommend to someone that couldn't take Bupropion due to history of seizures? seems like the only comparable medication in terms of activation is fluoxetine

[@DanGreer]

@@davelospinoso9022 I agree, not many antidepressants are activating like Bupropion. Fluoxetine would be the next one in my mind too, but it is a step below bupropion in terms of activation

[@Medhead101]

What about agomelatine and its efficacy and safety profile?

[@DanGreer]

Not sure that is not approved or used in the USA

[@ashrafal-junaid3864]

thank you so much!

[@David-yp5jf]

From the SSRI and SNRI which ones cause the least sexual side effects?

[@DanGreer]

It is hard to characterize because there are not head to head trials that study this. One published paper said fluoxetine has the least, but it did not include all SSRIs and SNRIs (www.ncbi.nlm.nih.gov/pmc/articles/PMC3108697/) Another study said duloxetine has less sexual side effects compared to escitalopram (pubmed.ncbi.nlm.nih.gov/17627739/) The best bet is to use antidepressants other than SSRI/SNRIs to decrease the chance of sexual dysfunction. Things like buproprion or mirtazapine.

[@David-yp5jf]

@@DanGreer Very intersting. What about trazodone¡

[@DanGreer]

@@David-yp5jf Trazodone has less sexual dysfunction than SSRI/SNRI and may even have a protective effect. The issue is that trazodone is very sedating and is taken twice per day in depression usually so people don't like feeling tired all the time. These days, low dose trazodone is commonly used just to help people sleep with a single dose before bed.