Treatment with SSRIs rather than placebo was associated with clinical improvement by the end of the first week of use .
CONCLUSIONS Treatment with SSRIs is associated with symptomatic improvement in depression by the end of the first week of use , and the improvement continues at a decreasing rate for at least 6 weeks
CONTEXT Selective serotonin reuptake inhibitors ( SSRIs ) are often described as having a delayed onset of effect in the treatment of depression .
However , some trials have reported clinical improvement as early as the first week of treatment .
OBJECTIVE To test the alternative hypotheses of delayed vs early onset of antidepressant action with SSRIs in patients with unipolar depression .
A double‐blind trial of fluoxetine, 20 mg, and placebo in out‐patients with DSM‐III-R major depression and melancholia
As part of a study in which reduced rapid eye movement latency was used to predict treatment response , fluoxetine and placebo were compared in 89 out patients with major depression with ( n = 52 ) and without ( n = 37 ) DSM-III-R melancholia , to determine whether the presence or absence of melancholia predicted antidepressant and /or placebo response . Following a 2-week , single blind placebo lead-in , men and women were assigned by r and om allocation to double-blind fluoxetine , 20 mg/day , or placebo for 8 weeks . Fluoxetine was statistically significantly superior to placebo in patients with melancholia  ( endpoint change in the Montgomery-åsberg Depression Rating Scale [ MADRS ] score , response rates and remission rates ) . A weekly analysis demonstrated statistical superiority of fluoxetine compared with placebo at week 3 and continuing for the remainder of the study . Fluoxetine was statistically significantly more likely to reduce suicidal ideation compared with placebo , using the MADRS item 10 ( suicidal ideation question )
Treatment with SSRIs rather than placebo was associated with clinical improvement by the end of the first week of use .
CONCLUSIONS Treatment with SSRIs is associated with symptomatic improvement in depression by the end of the first week of use , and the improvement continues at a decreasing rate for at least 6 weeks
CONTEXT Selective serotonin reuptake inhibitors ( SSRIs ) are often described as having a delayed onset of effect in the treatment of depression .
However , some trials have reported clinical improvement as early as the first week of treatment .
OBJECTIVE To test the alternative hypotheses of delayed vs early onset of antidepressant action with SSRIs in patients with unipolar depression .