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 .
Moclobemide versus fluoxetine in the treatment of inpatients with major depression.
Seventy in patients with a DSM-III-R major depression were included in a double-blind , r and omized , clinical trial to compare the efficacy and tolerability of moclobemide versus fluoxetine . After a 3-day placebo run-in phase , treatments were administered for 4 weeks in daily doses of between 300 and 600 mg of moclobemide or 20 to 40 mg of fluoxetine .  Efficacy was measured by the Hamilton Rating Scale for Depression ( HAM-D ) , Clinical Global Impression , and subjective mood ratings ( 45-item self-rating scale ) .  Fifty-three patients ( mean age , 40 years ; 22 men , 31 women ) completed the 4-week treatment . Changes between end of treatment and baseline did not differ between both study drugs . The HAM-D responder rate ( 50 % improvement from baseline ) was 59 % in the moclobemide group and 58 % in the fluoxetine group after 4 weeks . Moclobemide , however , acted therapeutically faster than fluoxetine . After 1 week of treatment , the HAM-D scores were significantly lower in patients on moclobemide than in those on fluoxetine ( p < 0.005 ) . The earlier efficacy of moclobemide after 1 week was also detected by the patients ' subjective mood ratings ( p < 0.02 ) . There were no differences between moclobemide and fluoxetine regarding tolerability ratings . These data suggest that both agents have a similar efficacy and tolerability but that moclobemide has an earlier onset of antidepressive action
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 .