However, as noted in USA Today, due to differences in onset of action, adverse effects, and of course, out-of-pocket costs, one antidepressant may be better for a given individual but not his/her twin sibling. The authors pointed out that it's reasonable to tailor antidepressant choice based upon (desired) side effect(s). For someone complaining of insomnia, we should consider a more sedating medication. For someone complaining of weight loss, we should consider an appetite stimulating medication. For someone complaining of sexual dysfunction, we should consider one w/less adverse sexual effects. And so on & so forth.
reanalysis of STAR*D turned up some issues w/bias & statistics such that antidepressants are only "marginally efficacious" when compared to placebo in treating major depression.
If this is indeed the case, it would certainly explain the difficulty we have in finding the right medication for each individual. More importantly, it raises the question of just how do we treat major depression?