Pharmaceutical firms want doctors to use the newest medications on the market—but that’s not always the right choice
Everyone secretly knows Nardil and Parnate (the two commonly-used drugs in the MAOI class) are excellent antidepressants1. Oh, nobody will prescribe them, because of the dynamic discussed here, but in their hearts they know it’s true.
SSRIs, the class which includes most currently used antidepressants, are very safe in the traditional sense of “unlikely to kill you”. Suicidal people take massive overdoses of SSRIs all the time, and usually end up with little more than a stomachache for their troubles. On the other hand, there’s increasing awareness of very common side effects which, while not disabling, can be pretty unpleasant. About 50% of users report decreased sexual abilities, sometimes to the point of total loss of libido or anorgasmia. And something like 25% of users experience “emotional blunting” and the loss of ability to feel feelings normally.