Posted by SLS on January 6, 2012, at 6:20:50
In reply to Re: when does prozac start working?confused,need help., posted by godess on January 6, 2012, at 4:14:10
One study conducted at Harvard/Mass General reported that if someone doesn't show any improvement by 4 weeks, the likelihood of obtaining a response falls off greatly thereafter. I think they looked at fluoxetine. I would still hold out for 6 weeks, though - maybe even 8 for fluoxetine.
The thing is, the beginnings of an antidepressant response might be so subtle, that the patient doesn't recognize it and aborts the trial prematurely. Using a depression rating scale during the trial might tease out small improvements.
- Scott
Found it:
------------------------------------------
http://www.ncbi.nlm.nih.gov/pubmed/10964858Am J Psychiatry. 2000 Sep;157(9):1423-8.
Timing of onset of antidepressant response with fluoxetine treatment.Nierenberg AA, Farabaugh AH, Alpert JE, Gordon J, Worthington JJ, Rosenbaum JF, Fava M.
SourceDepression and Clinical Research Program, Massachusetts General Hospital, Boston, MA 02114, USA. anierenberg@partners.org
Abstract
OBJECTIVE:The purpose of this study was to assess the time until onset of antidepressant response with fluoxetine treatment.
METHOD:The authors evaluated 182 outpatients with major depression who had a sustained acute response to fluoxetine treatment. The outpatients received 8 weeks of treatment with 20 mg/day of fluoxetine and were assessed biweekly with the 17-item Hamilton Depression Rating Scale. The onset of response was defined as a 30% decrease in score on the Hamilton depression scale that persisted and led to a 50% decrease by week 8. The Kaplan-Meier product limit and Cox regression analysis were used to model the relationship between relevant variables and time until onset of response.
RESULTS:The authors found that at weeks 2, 4, and 6, the probabilities of having an onset of response (for responders) were 55.5%, 24.7%, and 9.3%, respectively. The cumulative probabilities of onset of response at each time point were 55.5%, 80.2%, and 89.5%. Neither demographics nor clinical characteristics of depression predicted time until initial response.
CONCLUSIONS:These data suggest that more than half of eventual responders to fluoxetine treatment at 8 weeks start to respond by week 2; over 75% start to respond by week 4. Conversely, the lack of onset of response at 4-6 weeks was associated with about a 73%-88% chance that patients would not have an onset of response by 8 weeks.
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1006334
URL: http://www.dr-bob.org/babble/20111226/msgs/1006495.html