Montgomery S A, Pedersen V, Tanghøj P, Rasmussen C, Rioux P
St Mary's Hospital Medical School, London, UK.
Int Clin Psychopharmacol. 1994 Mar;9 Suppl 1:35-40. doi: 10.1097/00004850-199403001-00006.
Optimal dosing schedules for an antidepressant drug can only be established during clinical studies in depressed patients. The benefits of antidepressant therapy are usually progressive, and thus patients must be maintained on a particular treatment for at least 3-4 weeks to assess the efficacy of different doses. Meta-analysis, a widely accepted statistical technique which allows the combination of the results of multiple studies, was used to assess the efficacy of several doses of citalopram over nine placebo-controlled clinical trials. Statistically significant differences between citalopram and placebo were found at both the 20 and 40 mg dose levels. The minimal effective dose of citalopram was shown to be 20 mg. However, analysis of patient subgroups revealed a tendency for those patients suffering from severe or recurrent depression to achieve better results with a higher dosage (40 mg), while patients experiencing their first period of depression or with less severe depression responded well to the minimally effective dose of 20 mg.
抗抑郁药物的最佳给药方案只能在对抑郁症患者的临床研究中确定。抗抑郁治疗的益处通常是渐进的，因此患者必须持续接受特定治疗至少3至4周，以评估不同剂量的疗效。荟萃分析是一种广泛接受的统计技术，可将多项研究的结果合并，用于评估9项安慰剂对照临床试验中几种剂量西酞普兰的疗效。在20毫克和40毫克剂量水平上，西酞普兰与安慰剂之间均发现有统计学显著差异。西酞普兰的最小有效剂量为20毫克。然而，对患者亚组的分析显示，患有重度或复发性抑郁症的患者倾向于使用较高剂量（40毫克）能取得更好的效果，而首次患抑郁症或抑郁症较轻的患者对20毫克的最小有效剂量反应良好。
