Key result
Among 50,365 patients initiating SSRIs for depression, 54% of those <65 years and 79% of those ≥65 years never received a dose reported to exert maximum antidepressant effect.
Why the study?
Recent meta-analyses report a dose-response relationship for the antidepressant effect of SSRIs, but how these drugs are dosed in clinical practice was unclear.
Population
50,365 individuals in Region Västra Götaland, Sweden, with incident depression initiating SSRI treatment between 2007 and 2016
Comparison
SSRI doses required for maximum antidepressant effect vs sub-maximum doses
Design
Register-based longitudinal study
Authors
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Submaximal SSRI dosing appears common in depression care; this Level 3 evidence leaves open whether titration to meta-analysis maxima improves outcomes.
Cohort (n=50,365)
Most patients prescribed an SSRI for depression in clinical practice never receive the dose required for maximum antidepressant effect according to recent meta-analyses.
Lisinski et al. (2021) conducted a cohort in Depression (n=50,365). SSRI treatment was evaluated on Prescription of a daily dose required to elicit the maximum antidepressant effect. Among 50,365 patients initiating SSRIs for depression, 54% of those <65 years and 79% of those ≥65 years never received a dose reported to exert maximum antidepressant effect.
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