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Review: lower doses of antidepressant drugs are effective and have fewer adverse effects in depression

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 Questions In patients with depression, are high doses of antidepressants more effective than low doses, and how is safety affected?

Data sources

Studies were identified by searching Medline, Current Contents, and the Cochrane Collaboration Register of Trials; scanning the bibliographies of retrieved articles; and contacting authors.

Study selection

Randomised controlled trials were selected if they compared 2 different doses of the same antidepressant drug in patients with depression (>5 patients per treatment group) who were followed for at least 3 weeks.

Data extraction

Data were extracted on patient characteristics, treatment type, number of patients clinically improved (defined as a reduction of >50% of the total score on the Hamilton Rating Scale for Depression, moderate to marked improvement on the Clinical Global Impression Scale, or lack of relapse of depressive episode), and total number of side effects. All …

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  • Sources of funding: Angelini; Eli Lilly; Lundbeck; Ravizza; Roerig; SmithKline Beecham; Solvay Pharma.

  • For correspondence: Dr C Munizza, Centro Studi e Ricerche in Psichiatria, Piazza del Donatore di Sangue, 3, 10154 Torino, Italy. FAX +39-081-551-8295.

  • A modified version of the abstract and commentary also appears in Evidence-Based Mental Health