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

Abstract

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.