Differential period of onset of action of fluvoxamine, paroxetine and milnacipran for depression

Introduction Selective serotonin reuptake inhibitors (SSRIs) and dual serotonin and noradrenaline reuptake inhibitors (SNRIs) are the most commonly prescribed class of antidepressants, yet it is not known whether one is superior to another. Aims The purpose of this clinical practice was to compare the periods of onset of action of fluvoxamine, paroxetine and milnacipran. Methods A retrospective cohort analysis was carried out among out-patients with depression treated in the Department of Psychiatry, Kawasaki Medical School Hospital, Kurashiki, Japan, in 2000 and 2001. A total of 206 patients receiving fluvoxamine, paroxetine and milnacipran were identified. Results The cumulative percentage of responders receiving milnacipran reached over 80% after 4 weeks, but it did reach this level for fluvoxamine or paroxetine until after 6 weeks. Conclusions The differential period of onset of action should help guide clinicians in determining a suitable duration of antidepressants for depression. Copyright (C) 2003 John Wiley Sons, Ltd.