Duration of Antidepressant Drug Treatment: What Is an Adequate Trial?

doi:10.1001/archpsyc.1984.01790140028003

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Vol. 41 No. 3, March 1984

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Duration of Antidepressant Drug Treatment

What Is an Adequate Trial?

Frederic M. Quitkin, MD; Judith G. Rabkin, PhD, MPH; Donald Ross, PhD; Patrick J. McGrath, MD

Arch Gen Psychiatry. 1984;41(3):238-245.

Abstract

• Data from three six-week placebo-controlled randomizedantidepressant trials were pooled to test the hypothesis thata four-week trial is insufficient to reach a determination ofdrug failure in depressed patients. We compared global clinicalratings at weekly intervals for patients receiving drug andpatients receiving placebo and calculated the proportion ofpatients whose clinical status changed over time. We predicted,and found, that a significant proportion of patients who showedno clear-cut response at four weeks would show much improvementat six weeks in drug but not placebo conditions. Baseline ResearchDiagnostic Criteria diagnosis, baseline illness severity, anddrug dose adjustments after four weeks did not predict eitherlate clinical improvement or relapse between four and six weeks.Additional placebo-controlled studies are needed to replicateour findings concerning the advantage of extending trials tofive or six weeks in samples of patients of various depressivesubtypes.

Author Affiliations

From the New York State Psychiatric Institute (Dr Quitkin), and the Department of Psychiatry, Columbia University College of Physicians and Surgeons (Drs Quitkin, Rabkin, Ross, and McGrath), New York.

Footnotes

Accepted for publication April 25, 1983.

Reprint requests to New York State Psychiatric Institute, 722W 168th St, New York, NY 10032 (Dr Quitkin).

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