Is it true that older patients in general respond more slowly to antidepressant treatment and that it takes at least 12 weeks to identify nonresponders?
Beliefs that older patients in general respond more slowly to antidepressant treatment and that it takes at least 12 weeks to identify nonresponders are unsubstantiated. Another common belief is that a lower starting dose and slower dose escalation will improve drug tolerability in geriatric patients. The “start low, go slow” paradigm evolved when tricyclic antidepressants (TCAs) were the primary pharmacologic treatment for depression. Evidence does not support slow dose-escalation of TCAs to minimize side effects. Furthermore, the “start low, go slow” strategy is essentially untested for the selective serotonin reuptake inhibitors (SSRIs). Nevertheless, doses should be increased gradually. • How long does it take to see an appreciable response to an antidepressant medication? It may take several weeks to see an appreciable response to an antidepressant medication. The practitioner should assess the patient’s response within 2 weeks of initiating therapy. Informed decisions about chang
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