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, randomized, parallel-group, flexible-dose study to evaluate the tolerability, efficacy and effects of treatment discontinuation with escitalopram and paroxetine in patients with major depressive disorder
This multinational , r and omized , double-blind , flexible-dose study evaluated the short- and long-term antidepressant tolerability and efficacy of escitalopram and paroxetine .  Tolerability was assessed by monitoring adverse events throughout the study , and discontinuation events during brief treatment interruption and tapered withdrawal . Discontinuation-emergent effects were evaluated in two separate double-blind periods . First , to mimic the consequences of non-compliance , patients were r and omized to one of two treatment interruption periods ( placebo-substitution for 3–5 days ) . Second , patients were r and omized to a 1–2-week tapered withdrawal period r and omly scheduled between weeks 28 and 31 . The pre-specified primary efficacy endpoint was the mean change from baseline in total Montgomery – Åsberg Depression Rating Scale ( MADRS ) score at week 8 , using the principle of last observation carried forward . A total of 323 patients entered 8 weeks of double-blind treatment and received at least one flexible dose of escitalopram ( 10–20 mg/day ) or paroxetine ( 20–40 mg/day ) . Patients who demonstrated evidence of a significant clinical improvement ( Clinical Global Impression – Improvement of 1 or 2 ) at week 8 entered a 19-week , double-blind maintenance period during which they were treated with the same dose they received at week 8 , followed by a 1–2-week tapered withdrawal period . A total of 89 patients ( 28 % ) withdrew during the study ; significantly ( P<0.01 ) more patients withdrew from the paroxetine group ( 34 % ) than from the escitalopram group ( 21 % ) , and significantly ( P<0.05 ) more paroxetine patients withdrew due to lack of efficacy . The mean MADRS total score improved for both treatment groups from baseline to week 8 , with no statistical difference between groups . In severely depressed patients ( baseline MADRS total score ≥30 ) , escitalopram was superior ( P<0.05 ) to paroxetine at week 27 ( end of maintenance treatment ) . There was a high prevalence of sexual dysfunction at baseline : the mean Arizona Sexual Experience Scale ( ASEX ) score was approximately 20 points in both treatment groups . Mean total ASEX scores increased slightly above baseline values during the acute period and declined slightly below baseline values towards the end of the maintenance period . During taper and cessation of treatment , patients in the paroxetine group demonstrated significantly more discontinuation symptoms relative to escitalopram based on the Discontinuation Emergent Signs and Symptoms scores
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 .