For treating depression, which class of medication is considered first-line?

Selective serotonin reuptake inhibitors (SSRIs) are considered the first-line treatment for depression due to their favorable safety profile, ease of use, and effectiveness. SSRIs work by increasing the availability of serotonin in the synaptic cleft, which contributes to mood regulation and alleviation of depressive symptoms.

Their side effects are generally milder compared to other classes of antidepressants, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). TCAs can cause significant side effects, including cardiotoxicity and anticholinergic effects, which limit their use as first-line options. MAOIs, while effective, require dietary restrictions and careful monitoring due to the risk of serious side effects like hypertensive crises, making them less favorable as initial treatments.

Antipsychotics, on the other hand, are not primarily indicated for depression unless there is a specific co-morbidity or treatment-resistant depression, making them inappropriate as first-line agents for the general treatment of major depressive disorder. SSRIs provide a more suitable and commonly accepted starting point for managing depression in clinical practice.