The DOI matches its Crossref record.
Onset of action of antidepressants: results of different analyses
Abstract
Because the value of antidepressants is hampered by their delay in onset of action, considerable attention has been focused on developing a drug that acts more rapidly. However, although specific studies are now ongoing, there have been no peer-reviewed prospective onset of action trials published in the literature to date. Some data are currently available from post-hoc pooled analyses and numerous methods have been developed for evaluating the onset of action; these include the time to response, the time to onset of therapeutic effect, pattern analysis and survival analyses. Such an analysis of four large-scale, double-blind studies has provided evidence for an earlier onset of action with mirtazapine than with the SSRIs (fluoxetine, paroxetine and citalopram). Significant differences were seen between mirtazapine and the SSRIs after 1 week of treatment. This effect was consistent across the four different methodologies and appears to be due to a specific antidepressant effect rather than an early effect on, for example, sleep. These findings await confirmation from specifically designed prospective onset of action studies.
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Subjective complaints of insomnia or daytime somnolence are frequent in patients with depression or anxiety disorders treated with SSRI and SNRI.
“In a recent review article on the prevalence of treatment emergent insomnia and somnolence in depressed patients, it was shown that subjective complaints of insomnia or daytime somnolence were frequent in patients suffering from depression or anxiety disorders treated with SSRI and SNRI [16].”
From Effects of Antidepressants on Sleep (2017) · cites this paper as [16]
Based on FDA study register, average prevalence of treatment-emergent insomnia in clinical trials with SSRI was 17% vs 9% placebo.
“Based on data from the US Food and Drug Administration (FDA) study register [16], the average prevalence of treatment-emergent insomnia in clinical trials with SSRI was 17% as compared to 9% out of patients randomized to the placebo arm.”
From Effects of Antidepressants on Sleep (2017) · cites this paper as [16]
Average rate of treatment-emergent somnolence in SSRI-treated patients was 16% vs 8% placebo.
“The average rate of treatment emergent somnolence in patients being treated with SSRI amounted to 16%ascompared to 8% out of patients receiving placebo.”
From Effects of Antidepressants on Sleep (2017) · cites this paper as [16]
For mirtazapine, improvement of sleep quality after first dose is related to faster onset of antidepressant action.
“which was specially discussed for mirtazapine as related to the faster onset of antidepressant action [16].”
From Effects of Antidepressants on Sleep (2017) · cites this paper as [16]
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Cited by
Sorted by citations
Effects of Antidepressants on Sleep
Wichniak, A., Wierzbicka, A., Walęcka, M., & Jernajczyk, W. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0816-4 · Cited by 557
Schroeder, F. A., Lewis, M. C., Fass, D. M., Wagner, F. F., Zhang, Y.-L., Hennig, K. M., Gale, J., Zhao, W.-N., Reis, S., Barker, D. D., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0071323 · Cited by 146
Metadata
- Authors
- Thompson, C.
- Affiliations
- University of Southampton (GB)
- Corresponding author
- Thompson, Chris
- Venue
- Human Psychopharmacology: Clinical and Experimental
- Publisher
- Wiley
- Published
- 2002
- Volume
- 17
- Issue
- S1
- Pages
- S27-S32
- ISSN
- 0885-6222 (ISSN-L)
- 1099-1077
- OpenAlex
- W2025534441
- Cited by
- 92
- References
- 0
- Citations by year
- 2026: 10 · 2025: 4 · 2024: 1 · 2023: 6 · 2022: 4 · 2021: 6 · 2020: 4 · 2019: 1 · 2018: 2 · 2017: 4 · 2016: 4 · 2015: 2 · 2014: 2 · 2013: 3 · 2012: 2
- FWCI
- 2.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Psychopharmacology Clinical and Experimental (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- antidepressant onset of action, mirtazapine, selective serotonin reuptake inhibitors, fluoxetine, paroxetine, citalopram, time to response, pattern analysis, survival analysis, depression treatment
- MeSH terms
- Mirtazapine, Adrenergic alpha-Antagonists, Antidepressive Agents, Clinical Trials as Topic, Depressive Disorder, Humans, Mianserin, Psychiatric Status Rating Scales, Time Factors, Treatment Outcome, Selective Serotonin Reuptake Inhibitors
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