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تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Depression in adults: Antidepressant doses*

Depression in adults: Antidepressant doses*
Drug Usual total starting dose per day
(mg)
Usual total dose per day
(mg)
Extreme daily dose range
(mg)
Selective serotonin reuptake inhibitors
Citalopram 20 20 to 40Δ 10 to 40Δ
Escitalopram 10 10 to 20 5 to 30
Fluoxetine 20 20 to 60 10 to 80
Fluvoxamine 50 100 to 200 25 to 300
Fluvoxamine CR 100 100 to 200 100 to 300
Paroxetine 20 20 to 40 10 to 50
Paroxetine CR 25 25 to 50 12.5 to 62.5
Sertraline 50 50 to 200 25 to 300
Serotonin-norepinephrine reuptake inhibitors
Desvenlafaxine 25 to 50 50 to 100 50 to 400
Duloxetine 30 to 60 60 30 to 120§
Levomilnacipran 20 40 to 80 20 to 120
Milnacipran 12.5 100 to 200 50 to 300
Venlafaxine 37.5 to 75 75 to 375 75 to 375
Venlafaxine XR 37.5 to 75 75 to 225 75 to 375
Atypical agents
Agomelatine¥ (not available in United States) 25 25 to 50 25 to 50
Bupropion 200 300 (maximum single dose 150 mg) 100 to 450
Bupropion SR 12 hour 150 300 (maximum single dose 200 mg) 150 to 400
Bupropion XL 24 hour 150 300

150 to 450 (United States)

150 to 300 (Europe)
Bupropion hydrobromide 24 hour 174 348 174 to 522
Mirtazapine 15 15 to 45 7.5 to 60
Serotonin modulators
Trazodone 100 200 to 400 100 to 600
Vilazodone 10 40 10 to 40
Vortioxetine 10 20 5 to 20
Tricyclics and tetracyclics
Amitriptyline 25 150 to 300 10 to 300
Amoxapine 25 200 to 300 25 to 400
Clomipramine 25 100 to 250 25 to 300
Desipramine 25 150 to 300 25 to 300
Doxepin 25 100 to 300 10 to 300
Imipramine 25 150 to 300 10 to 300
Maprotiline 25 100 to 225 25 to 225
Nortriptyline 25 50 to 150 10 to 200
Protriptyline 10 15 to 60 5 to 60
Trimipramine 25 150 to 300 25 to 300
Monoamine oxidase inhibitors
Isocarboxazid 10 10 to 40 10 to 60
Phenelzine 15 15 to 90 7.5 to 90
Selegiline transdermal 6 mg/24-hour patch 6 to 12 mg/24-hour patch 6 to 12 mg/24-hour patch
Tranylcypromine 10 30 to 60 10 to 60

CR: controlled release; SR: sustained release; XL: extended release; XR: extended release.

* Total daily oral doses shown in table may need to be given as 2 or 3 equally divided doses per day, depending on specific antidepressant and other factors. For additional detail, refer to individual drug monographs included with UpToDate.

¶ Lower doses may be useful for initiating or maintaining patients who are older or medically compromised (eg, kidney or liver disease) or drug-sensitive patients, as well as patients with a low body mass index. High doses may be used for medications that are well tolerated but ineffective at lower doses. In patients with panic disorder, UpToDate contributors initiate treatment at one-half or less of the usual starting dose shown and titrate more gradually; refer to UpToDate topics on management of panic disorder.

Δ Maximum recommended dose of citalopram is 20 mg for patients >60 years of age, with significant hepatic insufficiency, or taking interacting medications that can increase citalopram levels. For more information refer to the UpToDate topic on unipolar depression in adults and selective serotonin reuptake inhibitors.

◊ Although desvenlafaxine doses up to 400 mg per day have been studied, there is no evidence that doses >50 mg per day provide any additional benefit.

§ Although duloxetine doses >60 mg/day did not confer additional benefit in clinical trials, individual patients may benefit from dose escalation up to a maximum of 120 mg/day.

¥ Agomelatine may be hepatotoxic and is contraindicated with any degree of liver impairment. Transaminase monitoring is required.

‡ Conservative starting doses shown in table are lower than starting doses shown in some other references. For additional information, refer to UpToDate topics on the treatment of depression with antidepressants as well as cyclic antidepressants and monoamine oxidase inhibitors for treatment of adults with depression.
Data from:
  1. The American Psychiatric Association Publishing Textbook of Psychopharmacology, 5th edition, Schatzberg AF, Nemeroff CB (Eds), American Psychiatric Association Publishing 2017.
  2. Kennedy SH, Lam RW, McIntyre RS, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 3. Pharmacological Treatments. Can J Psychiatry 2016; 61:540.
  3. Gartlehner G, Thaler K, Hill S, Hansen RA. How should primary care doctors select which antidepressants to administer? Curr Psychiatry Rep 2012; 14:360.
  4. UpToDate Lexidrug. More information available at https://online.lexi.com/.
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