Treatment Comparisons  ·  Reviewed by Dr. Ben Soffer, DO

Two options. Which is right for you?

Head-to-head treatment comparisons with decision frameworks for specific patient situations. Each guide includes a side-by-side breakdown, PMID-cited evidence, and where ketamine fits when neither option is enough.

depression · anxiety

Lexapro vs Zoloft

Two first-line SSRIs — when to pick one over the other

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depression · anxiety

SSRIs vs SNRIs

Two antidepressant classes — when each one is the better starting point

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depression · anxiety

Therapy vs Medication for Depression and Anxiety

Two evidence-based paths — when each one is the better starting point

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depression · anxiety

Lexapro vs Prozac

Two of the most-prescribed SSRIs — different half-lives, different tolerability profiles

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depression · anxiety

Wellbutrin vs Zoloft

Different mechanisms (dopamine vs serotonin) — when each is the better starting point

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treatment-resistant depression · severe depression

TMS vs ECT

Two non-pharmacological treatments for treatment-resistant depression — when each one is the right choice

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depression · anxiety (Lexapro only)

Lexapro vs Wellbutrin

SSRI vs NDRI — two fundamentally different mechanisms for depression

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depression · generalized anxiety

Cymbalta vs Effexor

Two SNRIs — when each one is the better SNRI choice

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depression · anxiety

Prozac vs Zoloft

The two oldest SSRIs — when to pick one over the other

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depression · insomnia (off-label for Trazodone, FDA-approved for Mirtazapine in some uses)

Mirtazapine vs Trazodone

Two sedating antidepressants — both used for depression-with-insomnia, but with very different profiles

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treatment-resistant depression · major depression with suicidal ideation

Ketamine vs Spravato

Racemic ketamine vs esketamine — same NMDA mechanism, very different access and cost

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treatment-resistant depression · anxiety

Sublingual vs IV Ketamine

At-home oral lozenges vs in-clinic IV infusions — same medication, very different patient experience

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treatment-resistant depression · PTSD

Ketamine vs Psilocybin

Two psychedelic mechanisms — legal at-home access today vs Schedule I with limited clinical pilots

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PTSD · treatment-resistant depression

Ketamine vs MDMA-Assisted Therapy

Two psychedelic-assisted therapies for trauma — one legally accessible now, one stalled in FDA review

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treatment-resistant depression · major depressive episode after antidepressant failure

Ketamine vs TMS

Pharmacological NMDA antagonism vs non-invasive magnetic brain stimulation — two treatment-resistant depression escalation paths

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treatment-resistant depression · severe depression with suicidal ideation

ECT vs Ketamine

Gold-standard TRD treatment with anesthesia + memory effects vs newer rapid-onset NMDA antagonist

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panic disorder · generalized anxiety

Klonopin vs Xanax

Two benzodiazepines with very different half-lives — when each is the better fit

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bipolar I disorder · bipolar II disorder

Lamotrigine vs Lithium

Two cornerstones of bipolar treatment — different strengths for different phases

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generalized anxiety disorder · chronic anxiety symptoms

BuSpar vs SSRI for Anxiety

Non-addictive anxiolytic vs first-line SSRI — when each is the better anxiety treatment

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treatment-resistant depression · major depression after antidepressant failure

Spravato vs TMS

FDA-approved esketamine spray vs FDA-approved magnetic stimulation — two paths through treatment-resistant depression

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generalized anxiety disorder · panic disorder

SSRIs vs Benzos for Anxiety

Chronic treatment without addiction vs fast-acting with dependence risk — modern guidelines and the case for first-line SSRIs

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major depression · generalized anxiety

Trintellix vs Lexapro

Newer multimodal serotonin modulator vs gold-standard SSRI — when each fits

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low focus and concentration · low energy and motivation

Adderall vs Wellbutrin

A stimulant for ADHD vs an antidepressant with focus/energy effects — different problems, overlapping symptoms

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fibromyalgia · diabetic peripheral neuropathy

Cymbalta vs Lyrica

An SNRI vs a gabapentinoid — two FDA-approved options for neuropathic pain and fibromyalgia

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depression · generalized anxiety disorder

Effexor vs Pristiq

Venlafaxine vs desvenlafaxine — a parent SNRI and its active metabolite

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major depression · treatment-resistant depression

Auvelity vs Spravato

Two of the newest rapid-acting depression treatments — both act on the NMDA/glutamate system

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More comparisons coming. Looking for a specific drug? The drug-interactions directory covers hundreds of individual medications and their ketamine-interaction profile.