SSRIs significantly increase the risk of both serious and non-serious adverse events .
The potential small beneficial effects seem to be outweighed by harmful effects .
Background The evidence on selective serotonin reuptake inhibitors ( SSRIs ) for major depressive disorder is unclear .
Methods Our objective was to conduct a systematic review assessing the effects of SSRIs versus placebo , ‘ active ’ placebo , or no intervention in adult participants with major depressive disorder .
Efficacy and tolerability of controlled-release and immediate-release paroxetine in the treatment of depression.
BACKGROUND Antidepressant efficacy may be compromised by early discontinuation of treatment secondary to common , treatment-emergent side effects , including nausea , agitation , and somnolence .  Paroxetine controlled-release ( CR ) was developed to improve general tolerability and , in particular , gastrointestinal tolerability . OBJECTIVE To determine the antidepressant efficacy and tolerability of paroxetine CR in adult patients 18 to 65 years of age with DSM-IV major depressive disorder . METHOD Paroxetine CR ( 25 - 62.5 mg/day ; N = 212 ) and paroxetine immediate-release ( IR ; 20 - 50 mg/day ; N = 217 ) were compared with placebo ( N = 211 ) in the pooled data set from 2 identical , double-blind , 12-week clinical trials . RESULTS Both paroxetine CR and paroxetine IR exhibited efficacy in major depressive disorder as assessed by the reduction in 17-item Hamilton Rating Scale for Depression total score compared with placebo . Moreover , depressed mood and psychic anxiety symptoms improved as early as treatment week 1 in the paroxetine CR group compared with the placebo group . After 6 weeks of treatment , response and remission rates were 41.5 % and 20.5 % for placebo , 52.8 % and 29.6 % for paroxetine IR , and 58.9 % and 34.4 % for paroxetine CR , respectively . After 12 weeks of treatment , response and remission rates were 61.2 % and 44.0 % for placebo , 72.9 % and 52.5 % for paroxetine IR , and 73.7 % and 56.2 % for paroxetine CR , respectively . Rates of nausea were significantly lower for paroxetine CR ( 14 % ) than for paroxetine IR ( 23 % ; p < or = .05 ) during week 1 . Rates of dropout due to adverse events were comparable between paroxetine CR and placebo , while significantly ( p = .0008 ) more patients treated with paroxetine IR withdrew from the study prematurely compared with those treated with placebo . CONCLUSION Paroxetine CR is an effective and well-tolerated antidepressant exhibiting symptomatic improvement as early as week 1 . Paroxetine CR is associated with low rates of early-onset nausea and dropout rates due to adverse events comparable to those of placebo . The clinical improvement seen with paroxetine CR , coupled with its favorable adverse event profile , suggests a benefit for therapeutic outcome with paroxetine CR
SSRIs significantly increase the risk of both serious and non-serious adverse events .
The potential small beneficial effects seem to be outweighed by harmful effects .
Background The evidence on selective serotonin reuptake inhibitors ( SSRIs ) for major depressive disorder is unclear .
Methods Our objective was to conduct a systematic review assessing the effects of SSRIs versus placebo , ‘ active ’ placebo , or no intervention in adult participants with major depressive disorder .