|
Medication |
Starting dose (mg/d) |
Usual dose (mg/d) |
|
Selective serotonin reuptake inhibitors | ||
|
Citalopram |
20 |
20-40 |
|
Escitalopram |
10 |
10-20 |
|
Fluoxetine |
20 |
20-60 |
|
Paroxetine |
20 |
20-50 |
|
Sertraline |
50 |
50-200 |
|
Fluvoxamine |
50 |
50-300 |
|
Serotonin-norepinephrine reuptake inhibitors | ||
|
Venlafaxine, immediate release |
75 |
75-375 |
|
Venlafaxine, extended release |
75 |
75-375 |
|
Duloxetine |
60 |
60-120 |
|
Norepinephrine-serotonin modulator | ||
|
Mirtazapine |
15 |
15-45 |
|
Dopamine-norepinephrine reuptake inhibitor | ||
|
Bupropion HCl, immediate release |
100 |
300-450 |
|
Bupropion HCl, sustained release |
150 |
300-400 |
|
Bupropion HCl, extended release |
150 |
300-450 |
|
For some of these medications (such as tricyclic antidepressants), the upper dosing limit reflects risk of toxicity or need for plasma level assessment, whereas others (such as selective serotonin reuptake inhibitors) can be used safely at higher doses. Elderly patients, patients with anxiety disorders, patients with liver disease or other major medical comorbidities should receive a lower starting dose. Starting doses should be increased gradually until therapeutic dose is reached or the patient achieves remission. | ||
|
HCl, hydrochloride. | ||