Patient : I am a fifty year-old male with a history of severe depression and anxiety, chronic insomnia, hypothyroidism, hypertension, acquired brain injury, sub-arachnoid haemorhage with mild-moderate cognitive deficit and binge-drinking. I am currently prescribed oxazepam and escitalopram replacing the prior prescription of desvenlafaxine. I have also been using over-the-counter purchased dexchlorpheniramine and previously, promethazine. What is the least anti-cholinergic, least weigh-gaining, least sexually impairing, antidepressant. I have read that bupropion counters weight-gaining sexual impairing side effects of SSRIs. Would there be any advantage to switching to sertraline or perhaps even tianeptine instead of an SSRI? I think I would prefer the latter.
Previously prescribed medications:
arbamazapine, lithium, amityptiline, dothiepin, olanzapine, mirtazapine, venlafaxine, desvenlafaxine, nitrazepam, oxazepam, alprazolam, diazepam lorazepam, temazepam, zolpidem.
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