[Is there a relationship between clinical efficacy and antidepressant dosage in major depression?].
Several methodological approaches enable to study dose-efficacy relationships with antidepressants: dose range studies with or without placebo, studies of dose augmentation in non responders, meta-analyses and concentration-efficacy studies. With tricyclic antidepressants, published data on dose-efficacy relationships are relatively scarce but often show that the higher dose is more efficacious than the lower dose. Results of concentration-efficacy studies show heterogeneity between tricyclic antidepressants. With selective serotonine reuptake inhibitors, systematic dose-efficacy and concentration-efficacy studies are available. They show that there is neither dose-efficacy nor concentration-efficacy relationships with SSRI. Venlafaxine has been systematically studied for a dose-efficacy relationship and results show a linear dose-efficacy relationship. Practical implications of these results are discussed.
Corruble
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Université Paris XI, Hôpital Universitaire Paul-Brousse, Villejuif.
Guelfi
J D
JD
D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage*; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage*; D003511:Cyclohexanols / Q000008:administration & dosage*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007099:Imipramine / Q000008:administration & dosage*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage*; D000069470:Venlafaxine Hydrochloride
D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D003511:Cyclohexanols; D007099:Imipramine; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride
Existe-t-il une relation entre efficacité clinique et posologie d'antidépresseurs dans la dépression majeure?