Conclusions : International differences in prescriber behaviour may influence , and in turn be influenced by , the conduct of clinical trials .
Objective : International differences are thought to exist in dosages used by clinicians treating mood disorders .
This study examined international dosage differences in antidepressant clinical trials , using a data base formed and maintained as a component of a Cochrane review of comparative clinical trials of fluoxetine .
Effectiveness of fluoxetine and doxepin in treatment of melancholia in depressed patients.
It has been suggested that serotonin reuptake inhibitors ( SSRIs ) may be less effective than tricyclic antidepressants ( TCAs ) in treatment of melancholic depression . We treated 36 depressed ambulatory patients with doxepin or fluoxetine  in a double-blind , r and omized 6-week trial with placebo run-in . Seven patients treated with doxepin and 13 patients treated with fluoxetine met diagnostic criteria for melancholic depression . Average daily dose was 169.4 + /- 41.6 mg for doxepin and 36.8 + /- 18 mg for fluoxetine . We observed a 50 % response rate in both treatment groups , using as outcome criterion reduction of Hamilton Depression Scale Score to less than 10 . Regardless of how strict the definition of response , we found fluoxetine to be as effective as doxepin in our group of melancholic out patients
Conclusions : International differences in prescriber behaviour may influence , and in turn be influenced by , the conduct of clinical trials .
Objective : International differences are thought to exist in dosages used by clinicians treating mood disorders .
This study examined international dosage differences in antidepressant clinical trials , using a data base formed and maintained as a component of a Cochrane review of comparative clinical trials of fluoxetine .