How Fast Are Antidepressants?
J Clin Psychiatry 2000;61(10):712-721
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: For years, investigators have
tried to determine the speed of onset of antidepressant drugs.
Claims that particular drugs may produce a faster response in
patients than other agents have been made, but such claims have
never been confirmed.
Method: The authors reviewed reports from
studies of the speed of onset of antidepressant therapies and
other studies that revealed information on this topic. We
compiled a list of factors that can affect the results of such
studies and interpretations of study results. In addition, we
reviewed literature concerned with methods of speeding up
Results: No antidepressant medication currently
available has been shown conclusively to have a more rapid onset
of action than any other. However, some methods of augmentation
may have the potential to speed responses. Somatic therapies such
as electroconvulsive therapy, phototherapy, and therapeutic sleep
deprivation may be the fastest options available at this time.
Conclusion: All available antidepressant
medications are usually taken for several weeks before future
responders will display a significant therapeutic benefit. If a
patient does not show at least a 20% improvement within the first
2 to 4 weeks of treatment, the treatment regimen should be
altered. For patients who do show early benefits from a
medication trial, one can expect additional benefits to accrue
over an 8- to 12-week period and to improve overall outcome
compared with those slower to respond. Future trials need to
address methodological confounds, but a truly "faster
antidepressant" will probably require new neuroscience