I can explain a metric fuckton regarding any pros or cons with these drugs. Doctors are nigh useless when it comes to explaining most of this shit, because the entire medical system is largely predicated on rather broken metrics.
First off, the "older" the drug is, the more side effects you can expect. Pharmaceutical developers kept trying to improve on whatever was the latest "hit" drug, by trying to more selectively target relevant transmitters. I know some patients "supposedly" do better on older drugs like Zoloft or Prozac, but I personally wouldn't want to touch those with a ten foot pole.
Another, somewhat newer issue that has been identified is that some people have mild genetic mutations that affect how relevant liver enzymes absorb these medications. I can't remember a good reference that covers all of this, but here's an example of one of those enzymes. A mutation can make a person absorb "more" of the medication (at a faster rate, or more in total, etc etc) or they can make a person absorb it at a reduced rate (or reduced in total), which throws off just about everything with regards to the balanced efficacy.
In addition to the above, sometimes a second, non-SSRI medication can actually impact absorption rates (IE, meds that have an "inducer" or an "inhibitor" effect on a particular enzyme).
Lastly, and this is the big one that doctors, pharmacies, pharmaceutical companies, and regulators have been trying to bury and ignore. There can be a dramatic difference in medication effects, between different manufacturers. Generic manufacturers specifically. The active ingredient is "supposedly" the same amount, but because of deviations in quality control, tablet-formula, etc etc, you could have wildly different results. You may even have cases where a patient does better on a specific generic brand than even the namebrand.
It's fucking nuts. Some generic manufacturers are almost consistently shit too. Especially those manufactured in India or Ireland. Also, because of how the system's set up, you have to go out of your fucking way just to even try to request specific generics from a pharmacy. And requesting namebrand for some medications is next to impossible, even if your insurance would cover it or if you'd be willing to foot the bill yourself.
I can explain a metric fuckton regarding any pros or cons with these drugs. Doctors are nigh useless when it comes to explaining most of this shit, because the entire medical system is largely predicated on rather broken metrics.
First off, the "older" the drug is, the more side effects you can expect. Pharmaceutical developers kept trying to improve on whatever was the latest "hit" drug, by trying to more selectively target relevant transmitters. I know some patients "supposedly" do better on older drugs like Zoloft or Prozac, but I personally wouldn't want to touch those with a ten foot pole.
Another, somewhat newer issue that has been identified is that some people have mild genetic mutations that affect how relevant liver enzymes absorb these medications. I can't remember a good reference that covers all of this, but here's an example of one of those enzymes. A mutation can make a person absorb "more" of the medication (at a faster rate, or more in total, etc etc) or they can make a person absorb it at a reduced rate (or reduced in total), which throws off just about everything with regards to the balanced efficacy.
In addition to the above, sometimes a second, non-SSRI medication can actually impact absorption rates (IE, meds that have an "inducer" or an "inhibitor" effect on a particular enzyme).
Lastly, and this is the big one that doctors, pharmacies, pharmaceutical companies, and regulators have been trying to bury and ignore. There can be a dramatic difference in medication effects, between different manufacturers. Generic manufacturers specifically. The active ingredient is "supposedly" the same amount, but because of deviations in quality control, tablet-formula, etc etc, you could have wildly different results. You may even have cases where a patient does better on a specific generic brand than even the namebrand.
It's fucking nuts. Some generic manufacturers are almost consistently shit too. Especially those manufactured in India or Ireland. Also, because of how the system's set up, you have to go out of your fucking way just to even try to request specific generics from a pharmacy. And requesting namebrand for some medications is next to impossible, even if your insurance would cover it or if you'd be willing to foot the bill yourself.