The newer antidepressants can be started at the full therapeutic dose, without having to titrate upwards. It is still possible to increase the dose two-or threefold if there is lack of response after 3 weeks. The reason for titrating the dose up for SSRIs would be to avoid panicky feeling and other transient side effects which sometimes occur when starting on an antidepressant. If this is a problem, it may be helpful to prescribe 2 or 3 days of benzodiazepines to tide the patient over the first days of treatment.
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Friday 7 November 2008
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