Controversies in Management: New or old antidepressants? New is better

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Abstract
The advantages of the new treatments are that they have fewer unpleasant side effects.4 Because of the absence of antimuscarinic effects, most of the new antidepressants have few of the troublesome effects of dry mouth, constipation, blurred vision, and tachycardia, and sedation is less of a problem because new treatments cause little blockade of histamine receptors. Less ataxia and incoordination in elderly people reduce the risk of falls, and postural hypotension is uncommon because of the absence of (alpha)1 receptor blockade. Weight gain and carbohydrate craving, a serious concern of many patients, are much reduced. These side effects are always unpleasant for patients, sometimes distressing, and occasionally fatal.

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