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 comparative study of the efficacy of long-term treatment with escitalopram and paroxetine in severely depressed patients
ABSTRACT Objective : This r and omised , double-blind , fixed-dose study evaluated the efficacy of escitalopram and paroxetine in the long-term treatment of severely depressed patients with major depressive disorder ( MDD ) . Research design and methods : Patients with a primary diagnosis of MDD and baseline Montgomery-Åsberg Depression Rating Scale ( MADRS ) ≥ 30 were r and omised to 24 weeks of double-blind treatment with fixed doses of either escitalopram ( 20 mg ) ( n = 232 )  or paroxetine ( 40 mg ) ( n = 227 ) . The primary analysis of efficacy was an analysis of covariance ( ANCOVA ) of change from baseline to endpoint ( Week 24 ) in MADRS total score ( last observation carried forward , LOCF ) . Main outcome measures ; results : At endpoint ( 24 weeks ) , the mean change from baseline in MADRS total score was –25.2 for patients treated with escitalopram ( n = 228 ) and –23.1 for patients with paroxetine ( n = 223 ) , result ing in a difference of 2.1 points ( p < 0.05 ) . The difference in the change in the MADRS total score ( LOCF ) was significantly in favour of escitalopram from Week 8 onwards . The proportion of remitters ( MADRS ≤ 12 ) after 24 weeks was 75 % for escitalopram and 67 % for paroxetine ( p < 0.05 ) . The results on the primary efficacy scale were supported by significantly greater differences in favour of escitalopram on the Hamilton Anxiety , Hamilton Depression and Clinical Global Impression-Improvement and -Severity scales . For very severely depressed patients ( baseline MADRS ≥ 35 ) , there was a difference of 3.4 points at endpoint in the MADRS total score in favour of escitalopram ( p < 0.05 ) . The overall withdrawal rate for patients treated with escitalopram ( 19 % ) was significantly lower than with paroxetine ( 32 % ) ( p < 0.01 ) . The withdrawal rate due to adverse events was significantly lower for escitalopram ( 8 % ) compared to paroxetine ( 16 % ) ( p < 0.05 ) . There were no significant differences in the incidence of individual adverse events during treatment . Conclusion : Escitalopram is significantly more effective than paroxetine in the long-term treatment of severely depressed patients
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 .