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Review: little evidence to support dose escalation of selective serotonin reuptake inhibitors in non-responders

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Q Is dose escalation of selective serotonin reuptake inhibitors effective for treating major depressive disorders in people who do not respond to standard doses?


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Systematic review.

Embedded ImageData sources:

MEDLINE, EMBASE, CINAHL, and PsycINFO (search date February 2005).

Embedded ImageStudy selection and analysis:

Included studies were randomised controlled trials (RCTs) or meta-analyses based on systematic reviews assessing the effects of dose escalation of selective serotonin reuptake inhibitors (SSRIs) for major depressive disorders not responding to standard SSRI doses. Studies were screened independently by two reviewers. Included studies were critically appraised, assigned a level of evidence, and data extracted using standardised forms and criteria. No meta-analysis was conducted due to heterogeneity of the timing of dose escalation.

Embedded ImageOutcomes:

Response (defined as ⩾50% reduction in Hamilton Rating Scale for Depression (HRSD) score or Clinical …

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