My psychiatrist usually makes the decision for me based on his experience with alleviating specific symptoms. I kind of prefer this approach, although everyone reacts different to medicines, the prescriber knows what has worked well in the past for specific symptoms in a class of medicine. A non-psychiatric example: I had a particularly bad case of strep, and my doctor told me he was going to prescribe a different drug than he normally did, because he didn't like the results he was seeing with this specific strain. (A common alternative was chosen, but his own experience with the medicines and the situation came into play). With my psych meds, Example: Wellbutrin is known to be a energy booster, and Paxil, another antidepressant is well known for its anxiolitic effects. The doctor has seen promise in his patients with these drugs and recommends them for those most debilitating symptoms.


I think it's great to have a discussion and options given with your psychiatrist, but personally I'm more than happy with the setup I have. It's slim pickings for psychiatrists in my area (he actually rotates through different counties and is only here 2x a month) so it's not that I'd have much of a choice anyway. lol