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 .
Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St John's wort): randomised controlled double blind non-inferiority trial versus paroxetine
Abstract Objective To investigate the efficacy of hypericum extract WS 5570 ( St John 's wort ) compared with paroxetine in patients with moderate to severe major depression . Design R and omised double blind , double dummy , reference controlled , multicentre non-inferiority trial . Setting 21 psychiatric primary care practice s in Germany . Participants 251 adult out patients with acute major depression with total score ≥ 22 on the 17 item Hamilton depression scale . Interventions 900 mg/day hypericum extract WS 5570 three times a day or 20 mg paroxetine once a day for six weeks . In initial non-responders doses were increased to 1800 mg/day hypericum or 40 mg/day paroxetine after two weeks . Main outcome measures Change in score on Hamilton depression scale from baseline to day 42 ( primary outcome ) . Secondary measures were change in scores on Montgomery-Åsberg depression rating scale , clinical global impressions , and Beck depression inventory . Results The Hamilton depression total score decreased by mean 14.4 ( SD 8.8 ) points , corresponding to 56.6 % ( SD 34.3 % ) of the baseline value , in the hypericum group and by 11.4 ( SD 8.6 ) points ( 44.8 % ( SD 33.5 % ) of baseline value ) in the paroxetine group ( intention to treat analysis ; similar results were observed in the per protocol analysis ) . The intention to treat analysis ( lower one sided 97.5 % confidence limit 1.5 points for the difference hypericum minus paroxetine ) and the per protocol analysis ( lower confidence limit 0.7 points ) showed non-inferiority of hypericum and statistical superiority over paroxetine . The lower limits in both cases exceeded the pre-specified non-inferiority margin of −2.5 points and the superiority margin of 0 . The incidence of adverse events was 0.035 and 0.060 events per day of exposure for hypericum and paroxetine , respectively . Conclusions In the treatment of moderate to severe major depression , hypericum extract WS 5570 is at least as effective as paroxetine and is better tolerated
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 .