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 .
A double-blind, multicenter study in primary care comparing paroxetine and clomipramine in patients with depression and associated anxiety. Paroxetine Study Group.
BACKGROUND 60%-90 % of patients with a primary diagnosis of depression also experience symptoms of anxiety , and such patients have a poorer prognosis than those with uncomplicated depression . The serotonin selective reuptake inhibitors have demonstrated efficacy in the treatment of both depression and certain anxiety states . Furthermore , in a meta analysis of the paroxetine clinical trial data base of 2963 patients in whom depression predominated , there was a concomitant reduction in the Hamilton Rating Scale for Depression anxiety factor . The purpose of the present study was to prospect ively compare the efficacy of paroxetine and clomipramine in patients specifically selected for coexisting depression and anxiety . METHOD This was a 12-week , double-blind , parallel-group trial comparing paroxetine 20 - 40 mg/day with clomipramine 75 - 150 mg/day in 1002 patients with a Montgomery-Asberg Depression Rating Scale ( MADRS ) score > or = 20 and a Clinical Anxiety Score ( CAS ) > or = 11 after a 3 - 7 day placebo run-in period . RESULTS Both paroxetine and clomipramine reduced the MADRS and CAS ratings at 2 , 6 , and 12 weeks and at endpoint , with no significant differences between treatment groups at any time point . CGI severity of illness and global improvement ratings were also similar throughout the trial ; however , there was a statistically significant difference in the CGI efficacy index at 6 weeks and at endpoint , favoring paroxetine ( p = .015 and p = .015 , respectively ) . Paroxetine result ed in fewer treatment-emergent adverse experiences and related withdrawals than clomipramine ( p = .025 and p = .008 , respectively ) . The number of serious adverse experiences was not significantly different in the paroxetine group compared with the clomipramine group ( 14 [ 2.8 % ] vs. 27 [ 5.4 % ] ) , but did approach statistical significance ( p = .056 ) . Anticholinergic-emergent adverse experiences were reported twice as frequently by patients in the clomipramine group as in the paroxetine group ( 36.1 % vs. 18.6 % ) . CONCLUSION There was no evidence of any significant difference in efficacy between paroxetine and clomipramine in patients with coexisting depression and anxiety . However , paroxetine was better tolerated as shown by total treatment-emergent adverse experiences , anticholinergic adverse experiences , and withdrawals due to adverse experiences
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 .