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 .
Onset and Early Behavioral Effects of Pharmacologically Different Antidepressants and Placebo in Depression
This study was aim ed at resolving the time course of clinical action of antidepressants ( ADs ) and the type of early behavioral changes that precede recovery in treatment-responsive depressed patients . The first goal was to identify , during the first 2 weeks of treatment , the onset of clinical actions of the selective serotonin reuptake inhibitor ( SSRI ) , paroxetine , and the selective noradrenergic reuptake inhibitor , desipramine ( DMI ) . The second aim was to test the hypothesis that the two pharmacologic subtypes would induce different early behavioral changes in treatment-responsive patients . The design was a r and omized , parallel group , placebo-controlled , double-blind study for 6 weeks of treatment following a 1-week washout period . The study utilized measures of the major behavioral components of the depressive disorder as well as overall severity . The results indicated that the onset of clinical actions of DMI ranged from 3 to 13 days , averaged 13 days for paroxetine , and was 16–42 days for placebo . Furthermore , as hypothesized , the different types of ADs initially impacted different behavioral aspects of the disorder . After 1 week of treatment , DMI produced greater reductions in motor retardation and depressed mood than did paroxetine and placebo , and this difference persisted at the second week of treatment . Early improvement in depressed mood – motor retardation differentiated patients who responded to DMI after 6 weeks of treatment from those that did not . Paroxetine initially reduced anxiety more in responders than in nonresponders , and by the second week , significantly improved depressed mood and distressed expression in responders to a greater extent . Depressed patients who responded to placebo showed no consistent early pattern of behavior improvement . Early drug-specific behavioral changes were highly predictive of ultimate clinical response to the different ADs , results that could eventually be applied directly to clinical practice
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 .