Table 10.

Choosing an antidepressant

Clear indication definition: Unequivocal diagnosis of the primary disorder andsecondary symptoms

Determination of target symptoms

Desired effect: Selection of the substance depending on its mode of action

Consideration of undesired side effects

Clear performance and long-term control strategy (advance information about side effects, delayed onset of action, and dose titration)

Some unique points of antidepressant treatment to consider

Same antidepressant may act differently in different patients

Antidepressant from the same group may act differently in the same patient

Antidepressant dose differs from patient to patient

Selection and indications of antidepressant may be made on basis of the side effects profile

The off-label use of antidepressants in dermatology is sometimes due to a lack of studies

A foresighted treatment plan and patient motivation are necessary to an extent, especially because the onset of effect is often evident only after couple of weeks

Antidepressant initial therapy is administered for 2-3 weeks before an optimal therapeutic dose range is found. Maximal-dose therapy should be administered for 6 weeks before efficacy is rated (or the substance changed)

The duration of therapy for the first appearance of disease is 6-9 months on average