Accelerating response to antidepressant treatment in depression: a review and clinical suggestions.

Abstract

OBJECTIVE:

The primary objective of this article is to review the literature regarding the speed of response to antidepressant drugs and potential strategies to accelerate the antidepressant response in new antidepressant-free patients with depression. Based on these data, we try to propose both an effective and safe antidepressant treatment strategy to alleviate depressive symptoms at the earliest opportunity.

DATA SOURCES:

Data were identified by searches of Medline (1966 to September 2009) and references from relevant articles and books. Search terms included depression, antidepressant, predictor, response, onset, acceleration, and augmentation. As our focus was on the acute phase treatment of depression, articles relevant to treatment-resistant depression were excluded. Only articles written in English or Japanese were consulted.

DATA SELECTION:

Studies, reviews, and books pertaining to the treatment of depression with a special regard to accelerating therapeutic effects were selected.

DATA SYNTHESIS:

Most of the available treatment guidelines for major depressive disorders recommend the continuous use of antidepressants for 4 to 8 weeks based on the idea of a delayed onset of response to these drugs. Contrary to this conventional belief, the recent data indicate that antidepressants start to exert their effects within 2 weeks and early non-response could predict a subsequent unfavorable outcome.

CONCLUSIONS:

These findings suggest the need of revisiting the timing of an antidepressant switch for early non-responders, whereby switching could be commenced in as early as 2 weeks.

• Authors: Shinichiro Nakajima, Takefumi Suzuki, Koichiro Watanabe, Haruo Kashima, Hiroyuki Uchida
• Journal: Progress in neuro-psychopharmacology & biological psychiatry (Prog Neuropsychopharmacol Biol Psychiatry) Vol. 34 Issue 2 Pg. 259-64 (Mar 17 2010) ISSN: 1878-4216 [Electronic] England
• PMID: 19969039 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright 2009 Elsevier B.V. All rights reserved.

Chemical References

• Antidepressive Agents
• Antipsychotic Agents

Topics

• Antidepressive Agents (therapeutic use)
• Antipsychotic Agents (therapeutic use)
• Depression (drug therapy)
• Drug Synergism
• Guidelines as Topic
• Humans
• MEDLINE (statistics & numerical data)