How do clinicians choose antidepressants?

A survey of the prescribing practice of a group of psychiatrists working in a Bristol NHS trust found that their preferred choice of antidepressants was surprisingly similar, but reported doses of antidepressants often fell below generally accepted minimum levels. Clinicians used mainly newer antidepressants rather than tricyclics. The choice of antidepressant was based on side effect profile, overdose danger, training and personal experience of efficacy. Cost and drug company advertising had little effect on choice. Difficulties in involving depressed patients in treatment decisions are discussed.