New Psychopharmacologic Treatment Strategies

Abstract

Letters4 December 2001New Psychopharmacologic Treatment StrategiesIra D. Glick, MD and Charles DeBattista, MDIra D. Glick, MDStanford University School of Medicine; Stanford, CA 94305Search for more papers by this author and Charles DeBattista, MDStanford University School of Medicine; Stanford, CA 94305Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-11-200112040-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Stokes' positive comments about our update. Regarding his concerns, first, we agree that lithium has a “clear early response.” Our point was that anticonvulsants, such as divalproex, may allow loading doses to be used, which may allow earlier onset of action (1). Second, although antidepressant effects may be seen in the first week, few clinical trials show a separation from placebo in the first week. Selective serotonin reuptake inhibitors start at full therapeutic dose, but there is likewise little evidence that they separate from placebo in the first week (2).