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 .
Inhibition of norepinephrine uptake in patients with major depression treated with paroxetine.
OBJECTIVE The study examined whether paroxetine inhibits the human norepinephrine transporter in addition to the human serotonin ( 5-HT ) transporter in patients with major depressive disorder . METHOD In an open-label , parallel-group , forced-titration study , 52 out patients with DSM-IV major depressive disorder and a baseline Montgomery Asberg Depression Rating Scale score > or = 20 were r and omly assigned to treatment with paroxetine ( to 60 mg/day ) or desipramine ( to 30 mg/day ) in a 3-to-1 ratio , respectively . Norepinephrine and 5-HT transporter function were assayed by using human transporter transfected cells in the presence of serum collected at baseline and the end of each treatment week . Data from 36 patients were analyzed . RESULTS Paroxetine decreased norepinephrine uptake to 73 % of control ( 27 % inhibition ) at an average serum concentration of 100 ng/ml and 57 % of control ( 43 % inhibition ) at 200 ng/ml . Uptake of 5-HT was decreased to less than 15 % ( greater than 85 % inhibition ) of control at these paroxetine concentrations . Desipramine decreased norepinephrine uptake to near maximal 15 % of control ( 85 % inhibition ) at 100 ng/ml . Uptake of 5-HT was decreased to 82 % of control ( 18 % inhibition ) at 100 ng/ml and 49 % of control ( 51 % inhibition ) at 500 ng/ml . CONCLUSIONS Paroxetine , currently classified as a selective 5-HT reuptake inhibitor , can act as a 5-HT/norepinephrine uptake inhibitor in vivo . The clinical significance of this action on norepinephrine uptake is currently unknown , but this action may contribute to the broad therapeutic efficacy of paroxetine in the treatment of depression , panic disorder , social anxiety disorder , posttraumatic stress disorder , and generalized anxiety disorder
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 .