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 .
[Efficacy and safety of fluoxetine versus clomipramine in ambulatory patients with a depressive syndrome in a clinical trial with private practitioners].
8 general practitioners and 7 specialists in the field of psychiatry and neurology participated in this study evaluating the results of fluoxetine treatment in out patients with depression in respect to safety and efficacy . They were familiarized with the requisite instruments by video rater training . The study was design ed as a r and omised double-blind parallel study involving 139 patients , comparing the effects of a daily dosage of 20 mg fluoxetine , 40 mg fluoxetine and 50 mg clomipramine . The number of patients treated in each group was 45 , 46 , and 48 , respectively and altogether 125 completed the four-week study ( five visits ) . A comparison of overall efficacy ratings showed significant antidepressant efficacy in all three treatment groups . On day 14 of the study ( visit 4 ) , patients receiving 40 mg fluoxetine showed significantly ( p less than 0.05 ) better global improvement than patients receiving clomipramine .  Treatment was well tolerated by all patients . The frequency of adverse events in response to fluoxetine was lower than under clomipramine treatment . On comparing treatment by psychiatrist and general practitioner no significant differences were found regarding age , sex , number of previous episodes and duration of the recent episode and outcome . Severe depression tended to be treated by psychiatrists ; general practitioners prescribed additional medication less frequently
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 .