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3Day to 2 Week Responses. Proof, not myth.

Posted by JohnL on October 28, 2000, at 8:59:45

Hi all,
In other threads there has been debate off and on about how long it takes antidepressants to work. I've seen antidepressant medication labels that say "though you may feel benefits in as little as 4 days, it may take up to 2 weeks for the effect". Anyone who knows me knows that I endorse Dr Jensen's views which are founded on quick responses. It's a lot more complicated than that, but that is the foundation. So I wondered, what is in peer-reviewed literature concerning this topic? I went to the research section of, typed in "early AND onset AND antidepressant", and clicked on GO. Below is just a sampling of what's out there in the clinical world.

I have shortened them with "..." for easier reading. But to read the whole thing, they're easy to find at There are plenty of others as well.

The last one in particular is the whole reason Jensen looked at quick responses not as a fluke, but as a real phenomenon that should be explored and utilized in practice. Especially if speed to recovery is at all important in someone's treatment. I don't mean this to be another pitch for Jensen, but rather evidence that quick responses (3 days to 2 weeks) do indeed exist in the peer-reviewed conventional psychiatric world we all subscribe to.

Also notice how different drugs all provided quick responses in a sizable portion of the population. I believe it was pure luck. That is, those patients who experienced quick response just happened by luck to choose a medication that 1)targeted their problem, 2)was a good molecular fit for their system. If we research this topic deeper, we find that these quick responses exist across the whole spectrum of psychiatric medications. A portion of every sample are going to get 'lucky'. An organized method to increase the odds of finding that lucky medicine is needed. Despite considerable skepticism at this board, that's what Jensen attempts to do. Read on.

1: Depress Anxiety 1999;9(2):54-60
Related Articles, Books, LinkOut
Double-blind comparison of citalopram and placebo in
depressed outpatients with melancholia.
Mendels J, Kiev A, Fabre LF
Therapeutic Services Inc., Philadelphia, Pennsylvania, USA
….On the HAM-D, citalopram patients exhibited significantly greater
improvement than placebo patients AFTER 1 WEEK of double-blind treatment
and at all subsequent study visits….
….results of this study indicate that citalopram is safe and effective in the
treatment of depressed patients with melancholia, and is associated with a
favorable side effect profile and a potentially rapid onset of action.

1: J Psychiatry Neurosci 2000 Sep;25(4):337-46
Preliminary randomized double-blind
placebo-controlled trial of tryptophan combined with
fluoxetine to treat major depressive disorder:
antidepressant and hypnotic effects.
Levitan RD, Shen JH, Jindal R, Driver HS, Kennedy SH, Shapiro
Clarke Division, Centre for Addiction and Mental Health, Toronto, Ont.
….[RESULTS: During the first week of treatment,
there was a significantly greater decrease in HDRS-29 depression scores,
and a similar trend in BDI scores, in the tryptophan/fluoxetine group than
in the placebo/fluoxetine group. No cases of serotonin syndrome occurred,
and the combination was well tolerated, although the 4 g per day dosage
of tryptophan produced daytime drowsiness. CONCLUSIONS:
Combining 20 mg of fluoxetine with 2 g of tryptophan daily at the outset
of treatment for major depressive disorder appears to be a safe protocol
that may have both a rapid antidepressant effect and a protective effect
on slow-wave sleep….

1: Brain Inj 1999 Aug;13(8):637-42
Moclobemide in the treatment of major depressive
disorder (DSM-3) following traumatic brain injury.
Newburn G, Edwards R, Thomas H, Collier J, Fox K, Collins C
Rotorua Rehabilitation Clinic, New Zealand.
…..Mean HAM-D reduction
was 81% and HAM-A reduction 81%. Of the 26 subjects 23 were
defined as responders. Onset of action was rapid, with 17 responding by
day 3.…

1: Encephale 1999 Jun;25 Spec No 2:49-54
Related Articles, Books, LinkOut
[Therapeutic action lag time and resistance to
Peretti CS
Service de Psychiatrie Adultes, CHU de Reims.
….The literature recommends at least two determinations per
week over the first two weeks of treatment….
….Venlafaxine seems to accelerate the response (day 4) and be superior to
a comparator (Clerc et al., 1996; Guelfi et al., 1995). The study conducted
by Guelfi, in France, in patients presenting with severe depression was
designed to evidence the efficacy of venlafaxine in melancholia. In 1996,
Benkert published a double-blind study comparing venlafaxine and
imipramine in severe depressions. Both studies stressed the rapid action
onset of venlafaxine (between day 4 and week 2) in severe depressions.

1: J Affect Disord 1999 Jun;53(3):275-8
Clonazepam in the treatment of prolonged depression.
Morishita S, Aoki S
Department of Psychiatry, Kawasaki Medical School, Kurashiki, Japan.
BACKGROUND: The purpose of this paper was to examine the optimal
adjunctive dose of clonazepam for the treatment of prolonged depression.
METHODS: Sixty nine patients with prolonged depression were enrolled
in an open trial over a 4 week period during which clonazepam was added
to their medication. RESULTS: A daily dose of 3.0 mg clonazepam as
augmentation was significantly more effective than doses of 1.5 mg and
below. Most of the improved patients showed a rapid onset of action
within 2 weeks, and side effects were not severe.

1: Int Clin Psychopharmacol 1997 Jul;12 Suppl3:S21-8
Early onset of therapeutic action in depression and
greater efficacy of antidepressant treatments: are they
Blier P, Bergeron R
Nurobiological Psychiatry Unit, McGill University, Montreal, Canada.
Until recently, several weeks of treatment were required to obtain a
clinically significant antidepressant response using pharmacotherapy. Now
treatment strategies have been developed that appear to produce an early
onset of action in major depression.. …
…..We conclude
that a treatment strategy producing a rapid onset often, but not invariably,
has greater efficacy than a treatment producing a slower onset. These
preclinical and clinical observations may help to devise rapid treatments
for major depression that will be effective in a greater proportion of
patients than at present.





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