Best Buy Drugs for depression

An estimated 14 percent of Americans will experience a serious bout of depression during their lifetime. Contrary to most ads that suggest medication is the only answer, the first step is to see your doctor and then a therapist. Talk therapy might be all you need to feel better. (It worked for our readers: According to our 2009 Annual Questionnaire, those who had at least seven counseling sessions reported just as much relief as those who only took medication. Those who did both fared even better.)

If an antidepressant is recommended, our Best Buy Drugs analysis finds that all are equally effective at relieving depression, so your choice might come down to safety, cost, and whether you have other medical conditions.

Our five CR Best Buy picks are inexpensive generic drugs with well-established safety profiles that will save you big bucks over brand-name drugs. Some are more likely to cause certain side effects than others, so make sure your doctor is aware of the side effects you especially want to avoid.

For example, paroxetine is associated with a higher risk of sexual problems; sertraline is associated with a higher rate of diarrhea. People respond differently to those medications, so you might have to try several before you find one that works. And even then, up to 40 percent of people who try antidepressants will not experience any relief.

But if you already take an antidepressant and it is working well for you, we do not recommend switching to another one.

CR Best Buys

• Generic bupropion
• Generic citalopram
• Generic fluoxetine
• Generic paroxetine
• Generic sertraline

These medicines are substantially less expensive than brand-name antidepressants and are equally effective. They are good options to try first.

Less impressive

• Desvenlafaxine (Pristiq). Available only since 2008, it does not have the long track record of other antidepressants.
• Duloxetine (Cymbalta)
• Venlafaxine (Effexor)

They are all expensive, brand-name drugs that are no more effective than the generic Best Buys.

Cymbalta vs. Fluoxetine

Antidepressants can help some people, but they aren’t always necessary. If you need one, the five inexpensive generics we recommend are good first options.