What to do When SSRI and SNRI Antidepressants don’t Work: A Guide for GPs

What to do When SSRI and SNRI Antidepressants don’t Work: A Guide for GPs

Depression is the most common mental health related presentation in general practice, but only a third of patients achieve remission with first line selective serotonin reuptake inhibitors (SSRIs), and many experience significant adverse effects. When SSRIs and serotonin-noradrenaline reuptake inhibitors (SNRIs) fail or cause intolerable side effects, GPs can switch to other antidepressants within the same class or between different classes. GPs can also increase doses, combine medications or augment treatment with antipsychotics. Although all antidepressants are more effective than placebo, their efficacy and tolerability differ. Consider referring patients for specialist review if treatment failure persists despite trialling other options.

Modern Medicine – Issue 2, 2025