In the past two years many of my patiens have been very curious about the FDA approval of some novel antidepressants,  Fetzima,  Trintellix, and Viibryd -- all of which have similar mechanisms of action to existing antidepressant.   So in considering their novelty - there isn't anything significantly new or different about what these medications are doing.   What is different - is that they present new possibilities for patients who have found it hard to tolerate earlier medications.  It's not that they're better -- it's more that they represent more options that can work with a wider range of genetic subtypes.  Selective serotonin reuptake inhibitors (Trinellix and Viibryd) and combined selective serotonin reuptake inhibitos (Fetzima) all have similar mechanisms of action -- but have very different structures.  Because of the different structures - they can interact quite differently with the overall functioning of the body.   So there is a wider range of possiblity here to expereince signifcantly fewer side effects -- particularly weight gain or sexual dysfunction -- and so they might be worth a try.   It's like adding a slight change of color to a flower.  It might not be noticeable to some, but to toehrs it can make a world of difference!

David Salvage, MD, FAPM

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