Reply to Letter to the Editor "Comparing the Efficacy and Safety of Fluoxetine and Venlafaxine in Outpatient Depression"

Letter to the Editor

Sir: In response to the letter from Dr. Michelson regarding the comparative study of venlafaxine and fluoxetine, although re-randomization after 3 weeks may have been ideal, the flexible- dose design of this study was selected to reflect clinical practice, where doses are adjusted based on patient response and tolerability. The hypothesis tested was not that responders are qualitatively different, but rather that patients requiring a higher dose of either drug for an insufficient response are qualitatively different from those responding at recommended initial doses of each drug.