Dosing of Selective Serotonin Reuptake Inhibitors

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Sir: I am writing to address an inaccuracy written about the dosing and administration of selective serotonin reuptake inhibitor (SSRI) medications in the article by Marken and Munro published in the December 2000 issue of the Companion.1 Contrary to the contention by Drs. Marken and Munro that sertraline is more effective at the high end of the dosage range, the evidence suggests that sertraline is effective at its minimum effective dosage of 50 mg across the range of indicated mood and anxiety disorders and that, for patients not achieving optimal response, dose titration occurs among all SSRI agents. In the section on Dosing and Administration, there is only 1 paragraph on the “dose-response” relationship and 1 reference to support its only point for this section: “Recent data and widespread clinical observation suggest that sertraline, unlike the other SSRIs, is more effective at the higher end of its dose range than at its recommended starting dose of 50 mg/day.”1(p205)​​

Prim Care Companion J Clin Psychiatry 2001;3(5):224-225