Fluoxetine and sertraline
dosages in major depression

Cantrell R, Gillespie W, Altshuler L
Department of Psychiatry, UCLA,
CA 90095-7057, USA.
Depress Anxiety 1999; 9(2):78-82


In a retrospective study, we sought to determine medication dosages usually prescribed to obtain euthymia in 59 outpatients with a diagnosis of major depression treated with fluoxetine or sertraline. Charts of veterans admitted to the outpatient mental health clinic at the West Los Angeles Veterans Hospital with a diagnosis of major depression and treated with either fluoxetine or sertraline were reviewed. Progress notes were analyzed for a 6-month time period after the initiation of the medication treatment, and improvement was rated by a physician blind to the drug used for treatment. No significant differences were found in overall response rates between the fluoxetine (81% responders) and sertraline (76% responders) groups. Eighty-one percent of the fluoxetine responders compared to 32% of sertraline responders were at the manufacturer's recommended starting dose (MRSD) at the time of clinical response. One-third of patients receiving sertraline were started on or rapidly titrated to more than 50 mg/day. When only those patients receiving an adequate trial of sertraline at 50 mg were considered, 47% required a dose increase to achieve a remission. These data suggest that 50 mg of sertraline may be inadequate for some patients to achieve a resolution of symptoms of major depression and that many clinicians currently prescribe in a manner suggesting that they believe the MRSD is a suboptimal dosage.
Sertraline and sex
Sertraline and OCD
Long-term sertraline
Sertraline v mirtazapine
Sertraline and depression
Sertraline and noradrenaline
Sertraline (Zoloft) : structure
SSRIs and sexual functioning
Sertraline and personality disorders
Sertraline (Zoloft): prescribing information (PDF)
Are SSRI antidepressants little better than placebos?
Non-melancholic depression: sertraline v imipramine

and further reading

Future Opioids
BLTC Research
Utopian Surgery?
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
Critique of Huxley's Brave New World

The Good Drug Guide
The Good Drug Guide

The Responsible Parent's Guide
To Healthy Mood Boosters For All The Family