Praxis Medical Insights

Est. 2024 • Clinical Guidelines Distilled

Made possible by volunteer editors from the University of Calgary & University of Alberta

Last Updated: 9/17/2025

Effectiveness of Cranial Electrical Stimulation Compared to Antidepressants for Depression and Anxiety

Evidence on Antidepressants for Depression and Anxiety

  • The American College of Physicians recommends second-generation antidepressants, including SSRIs, SNRIs, and others, for treating depression, with approximately 62% of patients achieving treatment response and 46% achieving remission during 6-12 weeks of treatment 1
  • For anxiety symptoms accompanying depression, the American College of Physicians found similar efficacy among various antidepressants, including fluoxetine, paroxetine, sertraline, bupropion, and venlafaxine 2
  • The American College of Physicians notes that while different antidepressants show similar overall efficacy, they may differ in onset of action, with mirtazapine showing a statistically significantly faster onset compared to citalopram, fluoxetine, paroxetine, or sertraline 1

Safety Considerations

  • Antidepressants are associated with various side effects, including nausea, diarrhea, headache, tremor, daytime sedation, decreased libido, failure to achieve orgasm, nervousness, and insomnia, according to the American College of Physicians 1

Clinical Recommendation

  • The American College of Physicians recommends antidepressants as the first-line pharmacological treatment for depression and anxiety due to their established efficacy and well-understood risk-benefit profile 2, 1