Further Notes on Drug Therapy

Abstract

I agree with most of Dr. Kline’s statements about the drug treatment of depression. For the benefit of the clinicians reading this section, I am providing a table (Table I) of the antidepressants available on a prescription basis in the United States at this time and their approximate effective dosages, as well as the dosage forms in which each is available. The reader who is also a careful student of package inserts will note that some of my dosage ranges slightly exceed the upper dosage recommended by the FDA and the company. Higher dosages should only be tried in patients who failed to respond at lower levels and showed no undesirable side effects at those dosages. In older patients who have had prior cardiovascular disease, consultation with an internist should be held and an electrocardiogram should be obtained before exceeding the upper “recommended” dosage. Where feasible, drug blood levels or platelet monoamine oxidase activity levels should be checked (see below).