Version May 2024
| SSRI | Usual starting dose per day (mg) | Dose titration increments based upon response (mg)* | Therapeutic dose range for OCD (mg/day) | Supratherapeutic dose range (mg/day) |
| Citalopram | 20 | 10 to 20 | 40 to 60¶ | Not recommendedΔ |
| Escitalopram | 10 | 10 | 20 to 40 | 60 |
| Fluoxetine | 20 | 20 | 40 to 80 | 120 |
| Fluvoxamine◊ | 50 | 50 | 200 to 300 | 400 |
| Fluvoxamine CR | 100 | 50 | 200 to 300 | 400 |
| Paroxetine | 20 | 10 to 20 | 40 to 60 | 100 |
| Sertraline | 50 | 25 to 50 | 200 to 300 | 400 |
NOTE: Lower doses may be useful for initiating or maintaining patients who are older or medically compromised (eg, heart failure, kidney or liver disease), or patients known to be sensitive to drug side-effects, as well as patients with a low body mass index. Extreme daily doses may be used for medications that are well tolerated but ineffective at lower doses.
For agent selection including considerations related to adverse effect profiles, refer to UpToDate clinical topic and separately available table of antidepressant adverse effects. For dose adjustments for drug interactions and other factors, refer to Lexicomp drug monographs included within UpToDate.SSRI: selective serotonin reuptake inhibitor; OCD: obsessive-compulsive disorder.
* UpToDate typically titrates to maximum tolerated dose within therapeutic dose range at weekly or twice monthly intervals; more rapid titration may be appropriate in some patients (refer to topic).
¶ Maximum recommended daily dose of citalopram is generally 20 mg for patients >60 years of age, with significant hepatic insufficiency, or taking interacting medications that can increase citalopram levels. For additional information, refer to UpToDate topic review of SSRI pharmacology, administration, and side effects.
Δ Supratherapeutic dosing is not recommended for citalopram because higher doses have been associated with greater risk of QTc prolongation.
◊ Fluvoxamine daily doses >100 mg should be given in two divided doses per day.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
