For example, if you're depressed, anxious, irritable and can't sleep, you might do better on Paxil than Prozac. Paxil can be mildly sedating, while Prozac can have the opposite effect. If, on the other hand, you're depressed, lethargic and have trouble getting out of bed, Prozac may make more sense. Even among drugs in the same class, these effects can differ tremendously. Compared with other SSRIs, for example, Zoloft tends to cause more nausea and diarrhea.
Sexual dysfunction can be among the most troubling side effects of depression treatment.
Just when the therapy seems to be improving many other aspects of life, some men begin to experience diminished desire for sex, find it difficult to become sexually aroused, or have trouble achieving orgasm. The problems can occur with MAO inhibitors, tricyclics, SSRIs and Effexor, affecting up to 20 percent of men and 2 to 3 percent of women. Sexual side effects are infrequent with Serzone, Wellbutrin and Remeron. Co-existing health problems sometimes help to guide the choice of an antidepressant. Marketed under the brand name Zyban, the drug is also used to help smokers give up tobacco.