We found no clear evidence that paroxetine was more or less effective compared with other antidepressants at increasing response to treatment at acute ( six to 12 weeks ) , early ( one to four weeks ) , or longer term follow-up ( four to six months ) .
Paroxetine was associated with a lower rate of adverse events than amitriptyline , imipramine and older ADs as a class , but was less well tolerated than agomelatine and hypericum .
Some possibly clinical ly meaningful differences between paroxetine and other ADs exist , but no definitive conclusions can be drawn from these findings .
In terms of early response to treatment ( one to four weeks ) there was moderate quality of evidence that mirtazapine was better than paroxetine and that paroxetine was better than reboxetine .
However there was no clear evidence that paroxetine was better or worse compared with other antidepressants at increasing response to treatment at any time point .
BACKGROUND Paroxetine is the most potent inhibitor of the reuptake of serotonin of all selective serotonin reuptake inhibitors ( SSRIs ) and has been studied in many r and omised controlled trials ( RCTs ) .
However , these comparative studies provided contrasting findings and systematic review s of RCTs have always considered the SSRIs as a group , and evidence applicable to this group of drugs might not be applicable to paroxetine alone .
The present systematic review assessed the efficacy and tolerability profile of paroxetine in comparison with tricyclics ( TCAs ) , SSRIs and newer or non-conventional agents .
OBJECTIVES 1 .
To determine the efficacy of paroxetine in comparison with other anti-depressive agents in alleviating the acute symptoms of Major Depressive Disorder.2  .
To review acceptability of treatment with paroxetine in comparison with other anti-depressive agents.3 .
To investigate the adverse effects of paroxetine in comparison with other anti-depressive agents .
Dose escalation vs. continued doses of paroxetine and maprotiline: a prospective study in depressed out‐patients with inadequate treatment response
In view of the fact that controlled prospect i ve studies on the benefits of dose escalation of the selective serotonin re‐uptake inhibitor ( SSRI ) paroxetine are lacking , we conducted a double‐blind , r and omized , parallel‐group multicentre study design ed to compare the possible benefits of dose escalation of paroxetine and maprotiline in patients suffering from major or minor depression according to modified Research Diagnostic Criteria ( RDC ) with inadequate treatment response . The study sample consisted of 544 out‐ patients with different degrees of severity of depression . Patients received either 20 mg paroxetine ( n=271 ) or 100 mg maprotiline ( n=273 ) for the first 3 weeks in a double‐blind manner . Response after 3 weeks was defined using explicit operationalized criteria . Patients with inadequate treatment response ( paroxetine group , n=86 ; maprotiline group , n=88 ) were again r and omized to either continuation of the previous dosage ( paroxetine , n=36 ; maprotiline , n=48 ) or increased doses , i.e. 40 mg paroxetine ( n=50 ) or 150 mg maprotiline ( n=40 ) , respectively . Intention‐to‐treat and completer analyses were performed . Defining response as a reduction in Hamilton Depression Rating Scale ( 17‐item version ) ( HAMD‐17 ) score of at least 50 % from baseline , no significant benefits of dose escalation were found for either paroxetine or maprotiline . Stratification according to baseline severity of depression also revealed no significant benefits of dose escalation . After dose escalation , new adverse events that had not been present during treatment with lower doses rarely occurred . Our results support the view that a dose of 20 mg paroxetine is optimal for the acute treatment of depression in the majority of patients
We found no clear evidence that paroxetine was more or less effective compared with other antidepressants at increasing response to treatment at acute ( six to 12 weeks ) , early ( one to four weeks ) , or longer term follow-up ( four to six months ) .
Paroxetine was associated with a lower rate of adverse events than amitriptyline , imipramine and older ADs as a class , but was less well tolerated than agomelatine and hypericum .
Some possibly clinical ly meaningful differences between paroxetine and other ADs exist , but no definitive conclusions can be drawn from these findings .
In terms of early response to treatment ( one to four weeks ) there was moderate quality of evidence that mirtazapine was better than paroxetine and that paroxetine was better than reboxetine .
However there was no clear evidence that paroxetine was better or worse compared with other antidepressants at increasing response to treatment at any time point .
BACKGROUND Paroxetine is the most potent inhibitor of the reuptake of serotonin of all selective serotonin reuptake inhibitors ( SSRIs ) and has been studied in many r and omised controlled trials ( RCTs ) .
However , these comparative studies provided contrasting findings and systematic review s of RCTs have always considered the SSRIs as a group , and evidence applicable to this group of drugs might not be applicable to paroxetine alone .
The present systematic review assessed the efficacy and tolerability profile of paroxetine in comparison with tricyclics ( TCAs ) , SSRIs and newer or non-conventional agents .
OBJECTIVES 1 .
To determine the efficacy of paroxetine in comparison with other anti-depressive agents in alleviating the acute symptoms of Major Depressive Disorder.2  .
To review acceptability of treatment with paroxetine in comparison with other anti-depressive agents.3 .
To investigate the adverse effects of paroxetine in comparison with other anti-depressive agents .