What is considered the first-line treatment for major depressive disorder?

Selective serotonin reuptake inhibitors (SSRIs) are recognized as the first-line treatment for major depressive disorder due to their favorable safety profile, tolerability, and efficacy. SSRIs work by increasing levels of serotonin in the brain, which is a neurotransmitter associated with mood regulation. This mechanism helps alleviate depressive symptoms.

The advantages of SSRIs over older classes of antidepressants, such as tricyclic antidepressants, include a lower risk of serious side effects and interactions, making them more acceptable for initial treatment options. Additionally, SSRIs have been shown to improve not only mood but also related symptoms such as anxiety and sleep disturbances, which are common in patients with major depressive disorder.

In contrast, while tricyclic antidepressants can be effective, they are often associated with more significant side effects and health risks, which can limit their use in first-line treatments. Atypical antipsychotics are used in certain cases, such as treatment-resistant depression, but they are not generally considered first-line options. Benzodiazepines, primarily used for anxiety and insomnia, have limited effects on depressive symptoms and are not indicated for treating major depressive disorder.

Therefore, due to SSRIs’ effectiveness, safety, and lower side effect profile, they are established as