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CME
Treating Depressive Disorders
 
Premenstual Dysphoric Disorder3
Level of Evidence Place in Therapy Medication Usual Daily Dose1 Cost per
Day2
Level I Evidence and generally tolerable side effect/safety profile. 1st choice FLUOXETINE
(Prozac) 		20-40 mg $1.08-2.16
PAROXETINE
(Paxil) 		20-40 mg $1.59-3.18
SERTRALINE
(Zoloft) 		50-150 mg $1.60-3.35
Level II evidence or Level I evidence but less tolerable side effect/safety profile. 2nd choice FLUVOXAMINE
(Luvox) 		100-200 mg $0.99-1.98
CLOMIPRAMINE
(Anafranil) 		100-250 mg4 $0.87-2.19
ALPRAZOLAM
(Xanax) 		0.75-1.5 mg $0.93-1.86
Level III evidence or Level I/II evidence and significantly less tolerable side effect/safety profile. 3rd choice NEFAZODONE
(Serzone) 		200-400 mg $0.93-1.86

NOTE: Non-responding patients should be switched to an alternative 1st choice agent prior to attempting a 2nd choice antidepressant.

 

1. Usual daily doses are provided unless otherwise stated. Consult the drug monograph for details on age and condition specific dosing.
2. Approximate costs were derived from the ODB formulary (#36) or manufacturers' price lists and do not include professional fees or markups.
3. There is presently some debate regarding continuous vs. intermittent dosing of antidepressant medication for the treatment of premenstrual dysphoric disorder. At this time, continuous doing is recommended, until further evidence is available.
4. Low dose based on clinical trial evidence.

From: CANMAT - Guidelines for the Diagnosis and Pharmacological Treatment of Depression (1st Edition Rev., 1999) Page 36.

Back to Managing Depressive Disorders - (Selections from: CANMAT - Guidelines for the Diagnosis and Pharmacological Treatment of Depression [1st Edition Rev., 1999])

 


Over one million Canadians suffer from some form of depressive illness.