How to choose the right medicine for different types of depression?

1. Depression is not one disease, but a combination of many types

In modern society, depression has become one of the most common mental health diseases in the world. According to statistics from the World Health Organization ( WHO ), approximately 280 million people worldwide are affected by depression, accounting for 3.8% of the world's population ( World Health Organization, 2023 ). However, depression is not a single disease, it contains multiple subtypes, and different types of depression require different treatment strategies.

Why Your Antidepressant Isn't Working Well

Many patients find that antidepressants are ineffective or even cause side effects after taking them. This is often because the drug selection is not suitable . For different types of depression, doctors will choose antidepressants with different mechanisms of action to achieve the best effect.

This article will help you understand the different types of depression and how to choose the antidepressant that's best for you .

 

2. Different types of depression and recommended medications

Depression can manifest differently for different people, and treatment requires a personalized approach. Here are the most common types of depression and their recommended medications:

 

🔹 1) Major Depressive Disorder (MDD )

Performance characteristics :

• Chronic low mood, lack of interest or pleasure

• Decreased energy, slow thinking, and decreased concentration

• Sleep disturbance (insomnia or hypersomnia)

• Changes in appetite (decreased appetite or overeating)

• May be accompanied by thoughts of self-harm or suicide

💊 Recommended drugs :

• Escitalopram (レクサプロ) : An SSRI drug. Clinical studies have shown that escitalopram can reduce depressive symptoms by 47% ( Baldwin et al., 2020 ).

• Zoloft : An SSRI drug. Studies have shown that Zoloft can effectively relieve symptoms of depression and anxiety, reducing anxiety scores by 55% ( Stein et al., 2019 ).

✅ Applicable people : Suitable for most patients with depression , especially those who are taking antidepressants for the first time.

 

🔹 2) Anxious Depression

Performance characteristics :

• In addition to depressive symptoms, there is also intense anxiety, tension, and irritability

• Overthinking and difficulty relaxing

• Excessive worry about the future and often feel insecure

• Mental and physical tension (eg, muscle tension, headache, upset stomach)

💊 Recommended drugs :

• Escitalopram : An SSRI drug that has good effects on both anxiety and depression. Studies have shown that it can relieve symptoms in 67% of patients with anxious depression ( Hirschfeld et al., 2002 ).

• Paroxetine : SSRI , suitable for patients with severe anxiety and depression, but the dosage needs to be gradually reduced when stopping the drug to prevent withdrawal reactions.

✅ Applicable people : Suitable for patients with depression and anxiety , especially those who suffer from insomnia and irritability due to anxiety.

 

🔹 3) Atypical Depression

Performance characteristics :

• Emotions are easily influenced by external factors (feeling happy for a short time when good things happen)

• Weight gain and tendency to overeat

• Feeling sleepy during the day and feeling listless all day

• Overly sensitive to other people's comments and easily hurt

💊 Recommended drugs :

• Duloxetine (サインバルタ) : An SNRI drug that increases both serotonin and norepinephrine . Studies have shown that duloxetine can increase patients’ energy levels by 42% ( Raskin et al., 2020 ).

• Venlafaxine (Ifenlafaxine) : A SNRI drug suitable for patients with atypical depression, especially those with low energy and weight gain.

✅ Applicable people : Suitable for patients with depression who have mood swings, increased appetite and low energy .

 

🔹 4) Bipolar Depression

Performance characteristics :

• Depressive episodes alternating with mania / hypomania

• Symptoms of depression are similar to those of typical depression, but common antidepressants may induce mania

• Manic phases are characterized by high energy, impulsivity, irritability, and overconfidence

💊 Recommended drugs :

• Paroxetine : Used under the guidance of a doctor, it can assist in the treatment of bipolar depression.

• Mood stabilizers (such as quetiapine, lamotrigine) : Often used with medications to prevent manic episodes.

✅ Applicable population : Suitable for patients with a history of mania / hypomania , who need to take the medicine under the guidance of a doctor.

 

🔹 5) Persistent depressive disorder ( Dysthymia )

Performance characteristics :

• Mild depressive symptoms lasting for more than two years

• Although not as severe as major depression, it still affects daily life

• May be habitually self-blaming, pessimistic, and lack expectations for the future

💊 Recommended drugs :

• Mirtazapine (Mirtazapine) : A tetracyclic antidepressant that can improve sleep quality and appetite . Studies have found that mirtazapine can increase deep sleep time by 35% ( Winokur et al., 2018 ).

• Vortioxetine (Trintrich) : A new generation antidepressant with the additional advantage of improving cognitive function.

✅ Applicable population : Suitable for patients with long-term mild depression but not seriously affecting their lives .

 

How to choose antidepressants scientifically?

Choosing the right antidepressant requires consideration of:

✅ Type of depression (typical, anxious, atypical, etc.)

✅ Symptom characteristics (such as insomnia, drowsiness, changes in appetite, etc.)

✅ Drug side effects (eg, SSRIs may affect sexual function, SNRIs may increase blood pressure)

Don’t choose medicine blindly! It is recommended to consult a professional doctor to develop a personalized treatment plan based on your specific situation.

 

Choosing the right medication makes depression treatment more effective

Different types of depression require different treatment plans. Scientifically selecting antidepressants can achieve the best results. If you are experiencing depression, please consult a professional doctor to find the treatment plan that best suits you.

📌 Depression can be treated, and scientific medication can help you regain the color of your life!