The Pharmaceutical Journal
Vol 277 No 7427 p598
18 November 2006

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SSRIs’ effect on depression apparent within first week

Treatment with a selective serotonin reuptake inhibitor (SSRI) is associated with symptomatic improvement in depression by the end of the first week, according to a meta-analysis published in the Archives of General Psychiatry (2006;63:1217).

The researchers analysed data from 28 trials involving 5,872 subjects who received an SSRI or placebo. The pattern of response seen was tested against alternative models of onset of response.

The researchers found that the model that fit best was that where the incremental treatment effect was greatest in the first week, with a gradual decline in the magnitude of incremental benefits week by week.

A secondary outcome indicated an increased chance of achieving a 50 per cent reduction in Hamilton Depression Rating Scale scores by one week with SSRI treatment compared with placebo (relative risk 1.64; 95 per cent confidence interval 1.2–2.25). The absolute benefits increase further with time, say the researchers, so prescribers will continue to need to wait several weeks for key treatment goals, such as remission, to be met.