The impact of neurochemical mediators on antidepressant effectiveness.

Despite marked differences in the psychobiological profiles of depressed patients, clinical research has not supported selection of antidepressant (AD) medications based on neurochemistry. Prescribers have been advised to start all patients on the same class of ADs and then switch or combine them until benefit is achieved. New research may transform this practice. By matching clinical moderators to neurochemical mediators, health professionals may finally be able to overcome the disappointing remission rates associated with initial AD treatments and avoid the progressively worsening results associated with current trial and error approaches.