Patients treated for major depression are likely to obtain optimal benefit with the lower dose range of second-generation antidepressants, a large review of published and unpublished trial data has found.

The findings, published in Lancet Psychiatry, will have clinical implications for some pharmacological treatment guidelines, the researchers say.

In a systematic review and dose-response meta-analysis of 77 studies with more than 19,000 participants (mean age of 42.5) and a median eight weeks’ treatment, the authors examined fixed doses of venlafaxine, mirtazapine and five SSRIs to determine the optimal dose.

They found that overall the lower range of licensed doses were most likely to achieve the optimal balance between efficacy, tolerability and acceptability.