Gregor et al. carried out a "naturalistic" study of selective serotonin reuptake inhibitors (SSRIs) using data from the Regenstrief Medical Record System. They analyzed the dosing of SSRIs in a cohort of 3350 outpatients of an urban teaching hospital. Of these, 2859 had received fluoxetine (Fx), 460 had received sertraline (St), and 31 had received paroxetine (Px). Mean daily doses were calculated for patients receiving Fx and St. A mean of 5.0% of all patients continuing Fx therapy had their daily dose increased with each prescription refill during the first nine prescriptions. A mean of 14.9% of all patients continuing St therapy had their daily dose increased with each prescription refill during the first nine prescriptions. The frequency of St dose increases was two to three times the rate for Fx. The authors used this information to compare the effectiveness of Fx and St for control of symptoms of depression during the initial stages of therapy.49
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