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The antidepressant effect of sertraline is not enhanced by dose titration:results from an outpatient clinical trial
Schweizer, E; Rynn, M; Mandos, LA; DeMartinis, N; Garcia-Espana, F; Rickels, K;
Univ Penn, Dept Psychiat, Mood & Anxiety Disorders Sect, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104 ders Sect, Philadelphia, PA 19104 USA Univ Connecticut, Ctr Hlth, Dept Psychiat, Storrs, CT 06269 USA Univ Connecticut Storrs CT USA 06269 Dept Psychiat, Storrs, CT 06269 USA Univ Sci Philadelphia, Dept Pharm Practice, Philadelphia, PA USA Univ Sci Philadelphia Philadelphia PA USA Practice, Philadelphia, PA USA
Titolo Testata:
fascicolo: 3, volume: 16, anno: 2001,
pagine: 137 - 143
antidepressant drugs; depression; sertraline; dose escalation; dose response; double-blind study;
Tipo documento:
Settore Disciplinare:
Clinical Medicine
Life Sciences
Indirizzi per estratti:
Indirizzo: Rickels, K Univ Penn, Dept Psychiat, Mood & Anxiety Disorders Sect, 3535 Market St,Suite 670, Philadelphia, PA 19104 USA Univ Penn 3535 Market St,Suite 670 Philadelphia PA USA 19104 SA
E. Schweizer et al., "The antidepressant effect of sertraline is not enhanced by dose titration:results from an outpatient clinical trial", INT CLIN PS, 16(3), 2001, pp. 137-143


A previous report suggested that 5 weeks of continued treatment with 20 mgof fluoxetine was approximately as effective as double-blind titration to a dose of 60 mg in patients who had failed to respond to 3 weeks of initialtreatment at 20 mg. The current study was undertaken to evaluate whether 150 mg of sertraline was any more effective than 50 mg in treating depressedpatients who were non-responders at 3 weeks. Ninety-one outpatients with DSM-IV major depressive disorder who had a 17-item Hamilton Depression Rating Scale (HAM-D) score greater than or equal to 18 were treated with open label sertraline for 3 weeks. Patients who did not achieve remission (definedas 17-item HAM-D total score less than or equal to 8 by week 3) were then randomized to 5 more weeks of double-blind treatment with either 50 mg of sertraline or immediate titration to 150 mg of sertraline. Efficacy was assessed at each visit with the HAM-D, Clinical Global Impressions (CGI)-severity and improvement scale, and the Hopkins Symptom Checklist. There were no significant between-group differences in clinical or demographic features at baseline for the three treatment groups. After 3 weeks of open-label treatment, 16 patients were not randomized, of whom II (69%) met responder criteria. The remaining patients were randomized, double-blind, to 50 mg of sertraline (n = 37; HAM-D = 19.2 +/- 5.0) or 150 mg of sertraline (n = 38; HAM-D = 18.4 +/- 5.0). PROC-Mixed analyses found no significant difference in slopes for any outcome measure when comparing 50 mg and 150 mg sertraline treatment groups. At week 8 (LOCF), the overall remission rate (HAM-D less than or equal to 8) for 3-week non-responders was 40%, with no statisticallysignificant between-group difference for the 50 mg versus 150 mg doses of sertraline (P > 0.10). A completer analysis yielded similar results. Adverse events were mostly mild on both doses of sertraline and led to few treatment discontinuations. The results suggest that for most patients continued treatment with 50 mg dose of sertraline yields a rate of antidepressant response that is comparable to what is achieved by dose escalation from 50 mg to 150 mg of sertraline after 3 weeks of treatment. While some patients clearly benefit from higher doses, the results of the current study are consistent with the lack of any evidence for a dose-response curve with sertraline in the treatment of depression. Int Clin Psychopharmacol 16:137-143 (C) 2001 Lippincott Williams & Wilkins.

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Documento generato il 02/04/20 alle ore 19:13:14