Antidepressant Medication Management | SSRIs & SNRIs | Dr. Farkas
Quick Answer

Antidepressant selection matches medication class to symptom profile, comorbidities, and side-effect priorities: SSRIs for most depression and anxiety presentations, SNRIs for depression with pain or fatigue, bupropion for atypical depression and sexual side-effect concerns, mirtazapine for insomnia and appetite, MAOIs for treatment-resistant cases. Dr. Farkas uses the PHQ-9 to measure response objectively.

Medically reviewed by Gabriella I. Farkas, MD PhD — Board-Certified Psychiatrist · Reviewed 2026-07-09 · MD/PhD Neuroscience · Zucker Hillside NIH Research Center
Related topics on this page: SSRI SNRI selection · antidepressant psychiatrist · MAOI expertise · antidepressant optimization

Frequently Asked Questions

How is the right antidepressant chosen?

Selection considers symptom profile (activation vs sedation), comorbidities (anxiety, insomnia, pain), tolerability priorities (sexual side effects, weight, GI), prior response, and drug interactions. STAR*D data show any single antidepressant produces remission in about one-third of patients — matching drug to patient matters.

What are MAOIs?

Monoamine oxidase inhibitors — an older class of antidepressants effective for atypical and treatment-resistant depression. They require dietary tyramine restriction and careful attention to drug interactions but remain valuable options in expert hands.

How long should I stay on an antidepressant?

For a first depressive episode, typically 9–12 months after remission. For recurrent depression, longer maintenance is often indicated. Discontinuation is planned and gradual.

Related pages

Medication Classes

Antidepressant
Medications

SSRIs, SNRIs, atypicals, TCAs, and MAOIs — each class works through a different neurochemical mechanism. Dr. Farkas selects based on mechanism, your history, side-effect profile, and what has or hasn't worked before.

30–60 min evaluation
🧠
MD/PhD neuroscience
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Aetna & Cigna
💻
SC · NY · VA telehealth
Antidepressants
Antidepressant Drug Classes
SSRIs · SNRIs · NDRIs · TCAs · MAOIs · Atypical antidepressants
MD/PhD-level prescribing — not pattern-matching
Measurement-based tracking at every follow-up
"No harm" philosophy — side effects are solved, not accepted
In-network: Aetna & Cigna
📅 Request an appointment → 📞 917-267-9678
Medication Classes

How Dr. Farkas approaches
Medications

Evidence-based, neurobiologically-informed. Every prescribing decision is grounded in mechanism — not tradition or trial-and-error.

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SSRI & SNRI Selection
Serotonin and norepinephrine reuptake inhibitors — first-line in most cases. Selection based on side-effect profile, drug interactions, and prior response.
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Atypical Antidepressants
Bupropion, mirtazapine, vortioxetine — valuable options when SSRIs fail or cause intolerable side effects. Different mechanisms, different side-effect profiles.
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TCAs & MAOIs
Reserved for treatment-resistant cases — powerful medications requiring careful monitoring and dietary awareness. Still highly effective when appropriate.
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Side Effect Management
Weight, sexual function, sleep, and energy are actively monitored. Side effects are addressed — not accepted. Switching or adding an antidote are always options.
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Adequate Trials
Many 'treatment failures' were actually inadequate trials — wrong dose, insufficient duration. Dr. Farkas distinguishes true non-response from undertreated response.
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Strategic Switching
When a medication isn't working, the switch is mechanistically informed — not just trying the next SSRI alphabetically.
The Process

From evaluation to
lasting results

1
Comprehensive Evaluation
30–60 minutes covering your full psychiatric, medical, and medication history. Nothing skipped — accuracy before action.
2
Neurobiological Strategy
Treatment selection based on mechanism, your history, and what's failed before. Not the next name in the algorithm.
3
Regular Monitoring
Validated outcome measures at every visit. Objective data drives every adjustment — symptom improvement and side effect burden both tracked.
4
Long-Term Optimization
Treatment evolves as your life does. Regular reviews ensure you're always on the lowest effective regimen with the highest quality of life.
Conditions Treated

Antidepressants is used to treat
these conditions

Major DepressionTreatment-Resistant DepressionGeneralized AnxietyOCDPTSDPostpartum DepressionPanic Disorder

Don't see your condition? View all 28 conditions treated →

Getting Started

What to expect at
your first appointment

New patient evaluations are 30–60 minutes — never a rushed intake. Dr. Farkas takes your full psychiatric, medical, and medication history before making any prescribing decisions. You'll leave with a clear diagnosis, a treatment plan that makes sense to you, and a follow-up already scheduled.

Telehealth available throughout South Carolina, New York, and Virginia. In-person at our Hilton Head Island, SC office.

30–60 minute evaluation — not a template intake
Full review of prior medication history and what's failed
Neurobiologically-informed prescribing, not trial-and-error
Measurement-based tracking at every follow-up visit
No-harm philosophy — side effects are solved, not tolerated

Ready for prescribing done
at the MD/PhD level?

30–60 minutes. Expert diagnosis. A treatment plan built around your specific neurobiology and goals.

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