[pedagogue]

Each kind of anti-depressant has positives and negatives. Typically prescribers will try an SSRI / SNRI first because their side effect profiles 'tend' to be less severe, though there are various medical conditions that can make selection more complicated.

There can also be some economics involved. If something is still under patent, the doc is MUCH more likely to have free samples (drug reps influence) available. I believe most/all of the current TCAs are off-patent, so there are generics available, which may or may not influence a doc's chance of prescribing it. State hospitals, VAs, etc....they usually stick with generics, so you probably will be much more likely to get a generic from than, then say a GP or FP. MAOI's are typically a 3rd-line choice because they can be a pain to adjust to (because of the nutritional requirements, etc), however in the right cases...they can be very effective.

I believe in giving someone the best med for their situation, but sometimes economics effect that choice.

-p