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 .
Paroxetine in the Treatment of Elderly Depressed Patients in General Practice: A Double‐Blind Comparison with Amitriptyline
A total of 101 patients entered a double-blind , parallel-group study in general practice , comparing the efficacy and tolerability of paroxetine and amitriptyline in elderly depressed patients . All patients received placebo for 1 week followed by active therapy for a total of 6 weeks . Medication was r and omly allocated , two-thirds of the patients took paroxetine ( 20 mg daily ) and one-third received amitriptyline ( 50 mg daily ) ; this dose was increased to 30 mg and 100 mg , respectively , after 1 week . Of the patients who entered the placebo run-in , 90 took active treatment and were evaluable on an intention-to-treat basis ( 56 paroxetine , 32 amitriptyline ) . The mean age of the patients was 72 years . Significant reductions in Hamilton Depression Rating Scale ( HAMD ) from baseline to the end of treatment were seen for both groups ( p < 0.01 ) , with no difference between treatments . The HAMD score was reduced by half , or more , for 76 % of patients taking paroxetine and 86 % taking amitriptyline . Significant improvement was observed in the investigators ' Clinical Global Impression ( CGI ) score for 57 % of patients taking paroxetine and 52 % on amitriptyline . Improvements after treatment were also observed in the Leeds Sleep Evaluation Question naire ( LSEQ ) scores . Significantly fewer patients taking paroxetine reported adverse events ( 34 % vs 63 % taking amitriptyline , p = 0.02 ) . Those taking paroxetine experienced significantly fewer anticholinergic side effects ( 7 % vs 25 % taking amitriptyline , p = 0.04 ) . Overall , this study confirmed the effectiveness of paroxetine as an antidepressant drug . The relatively low incidence of adverse events , compared with amitriptyline , particularly the anticholinergic side effects which may be associated with disturbances in cognitive function , makes paroxetine suitable for the treatment of elderly depressed patients in general practice
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 .