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 .
Fluoxetine and desipramine in major depressive disorder.
The efficacy and safety of fluoxetine and desipramine were compared in a 6-week double-blind , parallel group study of patients with major depression . Twenty-five were studied while hospitalized for treatment , and 33 were studied as out patients . Improvement on the Hamilton Rating Scale for Depression was significant for both treatments from week 1 through the end of the study and did not differ between the two treatments at any week . Overall , 64 % of fluoxetine-treated patients and 68 % of desipramine-treated patients had at least a 50 % reduction in Hamilton Depression score . We assessed whether improvement relatively early in treatment was predictive of categorical response at 6 weeks . Among fluoxetine-treated patients , but not desipramine-treated patients , the week 3 change in the Hamilton Depression mood item was significantly predictive of the response at 6 weeks . Patients treated with fluoxetine had significantly fewer side effects than those treated with desipramine . Desipramine , but not fluoxetine , caused a persistent increase in heart rate . The results suggest that early signs of response to fluoxetine are not dependent on achieving steady-state levels of the drug
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 .