You tried Zoloft. It made you numb. You switched to Paxil. It brought insomnia, jaw clenching, and nausea. Still, feeling low? You’re back, asking: what’s the best antidepressant for depression and anxiety?
First up: anxiety. It’s not just stress. It’s like an alarm that won’t stop ringing. Your heart races, even in calm places. Depression? It’s not just sadness. It feels like being stuck. You stare at the walls. Time slips away.
Together, anxiety and depression crush motivation, sleep, and connection. What’s the fix? Medications? You’ve probably tried them. Now, it’s time to talk about something different. Not another SSRI. Not another waiting to feel okay.
Let’s talk about Ketamine-Assisted Therapy—why it’s rising fast in the field and why it is your next right step. Let’s ask hard questions and find honest answers.
Zoloft Gained Fans. Then Lost Them Fast. Why?
The Numbness Surprised People.
Zoloft (sertraline) is an SSRI. It fights anxiety and depression. It’s been around forever. At first, people loved it for its stability. Soon, many felt flat and numb.
In 2023, Langley and colleagues ran a double-blind, placebo-controlled study and tested 66 healthy adults in Copenhagen. The researchers gave half a 20 mg dose of escitalopram (another SSRI) and the other half a placebo. The goal wasn’t to treat depression. They wanted to see how SSRIs affect thinking and emotions.
Langley et al. used tricky tasks to see how brains responded. Results showed those on SSRIs reacted less to feedback, didn’t adapt quickly, and struggled to change their behavior based on good or bad outcomes. This matters, as it ties to the “blunting” effect Zoloft users often report.
And that blunted feeling is real. Ketamine, in contrast, is known for enhancing emotional access, not muting it. People describe breakthroughs, not flatlines. That’s a different kind of hope.
Zoloft Works—If You Watch It Closely.
Zoloft helps individuals with panic attacks or ruminating thoughts. It’s a top choice for anxiety and depression. But getting the right dose is key.
A 2023 dose-response meta-analysis by Luo and colleagues analyzed 21 trials with over 4,200 patients on sertraline. They checked how different doses affected depression, side effects, and dropout rates. The results were clear. Higher doses led to better improvements, but only to a point. Between 50 mg and 150 mg, side effects decreased a bit. Go higher, and the side effects returned.
Still, it takes weeks to kick in. Ketamine works differently. Many feel relief within hours to days, not weeks. In a mental health emergency, speed matters.
Lexapro: Looked Promising, Until It Didn’t.
People Slept Too Much. Or Not At All.
Lexapro (escitalopram) often ranks high on antidepressant lists. But, in a 2011 study by Stein and Lopez, the sleep effects sounded alarm bells. The researchers looked at over 7,000 patients. About 47% with major depression felt overly sleepy, while 23% struggled with insomnia. Although it helped sleep a bit compared to placebo, many users had concerns about the side effects.
It Helped With Racing Thoughts.
On the bright side, Lexapro worked wonders for obsessive-compulsive disorder (OCD). It lowered OCD symptoms better than a placebo. Yet, some OCD symptoms, like hoarding, floundered with Lexapro.
Ketamine, by contrast, doesn’t follow the same SSRI side effect pattern. Many report deeper rest and more vivid emotional processing, without the jittery sleep cycles or emotional fog.
Paxil: Promised Relief, but Withdrawals Bit Hard.
Discontinuation Became the Problem.
Paxil (paroxetine) packs a punch against anxiety and depression. But stopping it can be a real struggle. In July 2024, a meta-analysis by Lewis and Lewis in The Lancet Psychiatry analyzed 79 studies with over 21,000 patients. They found about 15% faced withdrawal symptoms when stopping. 3% had severe symptoms, like dizziness and insomnia. Paxil showed a higher risk for these withdrawal issues compared to other antidepressants.
Non-Specific Symptoms and the Nocebo Effect.
Funny enough, Lewis and Lewis explored the nocebo effect. It means patients feel symptoms because they expect to feel bad—even when they’re off the pill—for about 17% of placebo-stop patients. So, nearly half the withdrawal symptoms might not be from the actual pills but from what patients believed.
It Does Work Fast.
Yes, Paxil works quicker than others. But that speed comes with baggage. Ketamine also works fast—sometimes within hours—and without the daily pill and long-term tapering mess.
Prozac: Returned. Again. Somehow.
It Made Anxiety Worse Before It Helped.
Prozac (fluoxetine) is the grandpa of SSRIs. It helps—but starting it can feel rough for anxious individuals. A study by Näslund et al. (2017) reviewed data from over 8,000 SSRI patients. They found those on Prozac experienced increased anxiety at first. In the first week, 9.3% felt extra somatic anxiety compared to 6.7% on placebo.
It Helps Long-Term.
Despite the early jitters, Prozac’s long-term perks stood out. After a week, people using SSRIs noticed decreased anxiety (7.0% vs. 8.5% that took a placebo), as shown by the study of Näslund et al. It lasts longer in the body, making it easier to deal with missed doses.
For chronic depression paired with mild anxiety, fluoxetine is a solid choice. Just be ready for that bumpy start.
In contrast, Ketamine doesn’t make you feel worse before it helps. There’s no wait for your brain to adjust over weeks. That’s why it’s gaining traction for treatment-resistant depression.
Effexor: Took a Side Route, Sometimes Helped.
The Side Effects Were Weird.
Effexor (venlafaxine) is an SNRI. It tackles norepinephrine and serotonin. A 2024 meta-analysis by Kamp et al. showed Effexor has side effects. With over 6,000 participants, they found a serious event risk of 2.66 for issues like sexual dysfunction and anorexia. Nausea, dizziness, dry mouth, insomnia, and constipation greatly increased for Effexor users compared to placebo.
It Worked for Treatment-Resistant People.
Knowing these risks is vital. Effexor can help those whose previous antidepressants didn’t work. But Ketamine is now leading that treatment-resistant conversation. For those who’ve cycled through every SSRI and SNRI combo, KAT offers a reset—not a rehash of the same formulas.
Wellbutrin Refused to Play By SSRI Rules.
It Made Some People Anxious.
Wellbutrin (bupropion) is a different kind of antidepressant. It targets dopamine and norepinephrine. A 2023 retrospective study by Poliacoff et al. used data from 8,457 patients in a tele-mental health service. It compared how anxiety levels changed over time between those on Wellbutrin and those on SSRIs.
Initially, patients on Wellbutrin reported higher anxiety. But, after matching groups on 17 factors like age and depression severity, the difference disappeared after 6 and 12 weeks. Both groups improved similarly over time.
It Helped With Fatigue and Libido.
Also, Wellbutrin is great for low-energy depression. It improves energy without causing sexual issues common with SSRIs.
Ketamine? It improves energy, clarity, and focus in a single monitored session. No long adjustment curve. No libido crash.
Still, What’s the Best Antidepressant For Depression and Anxiety?
If you’ve tried all the usuals—and you’re still asking—that’s your answer. SSRIs and SNRIs work for some. But many people spend years jumping from one to another, hoping for the right mix.
That’s why Ketamine-Assisted Therapy is changing the landscape. It’s fast. It’s not daily. It opens a new neural window for reflection, growth, and healing—especially when paired with professional therapy.
At Felicity Mental Health, we don’t play guessing games. We use gene testing, 1:1 clinical support, and safe, supervised ketamine sessions to treat depression and anxiety without the trial-and-error slog.
Are you still switching pills? Still waiting for clarity? Or are you ready for something that works?
Let’s stop the loop. Call Felicity Mental Health today.
