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So the question is: "How do you decide what's the best medicine for which patient?"
My overarching statement about medications is that medications work for many people,
they're readily available, there are many knowledgable, prescribing physicians,
psychiatrists and primary care docs in particular,
who know the literature and know that these medications work.
The two medications that have FDA approval are both the same kind of drug.
They're both antidepressants. They're both SSRIs, selective seratonin reuptake inhibitors,
so the choice of one or the other really depends more on the clinician's familiarity with the drug.
It really doesn't make much of a difference. Sometimes it doesn't work, and sometimes people just don't tolerate the medication very well,
so then you sort of have to look at the "A-" or "B+" lists.