ABSTRACT
Duration of Drug Trial The other major mistake concerns duration of a drug trial before deciding the drug is ineffective. These drugs almost always take 1 to 2 weeks before they start to work. Only a minority of patients who eventually benefit show any improvement after 2 weeks of treatment [8]. The time it takes to go from a symptomatic state to a relatively symptom-free one can vary. Some patients show no improvement for 3 to 4 weeks and suddenly improve; others gradually get better over 2 weeks. Two studies demonstrate that patients on a fixed dose of an antidepressant who have not improved at 4 weeks have a far greater chance of improving when the drug is extended to 6 weeks than those on placebo [9,10]. Therefore, patients should not be considered to be unresponsive until they have received a minimum of a 6week trial of the antidepressant with a dose close to the maximum for at least 10 days.
