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 .
Efficacy and Safety of Tianeptine in Major Depression
Abstract Objective : This study was performed to compare the efficacy and safety of tianeptine and paroxetine in the treatment of major depression . Anxiolytic drug use was systematic ally reported to provide an indirect evaluation of the anxiolytic activity of both treatments . Zopiclone use was assessed to provide an indirect evaluation of the possible hypnotic activity of both treatments . Design and Setting : This was a 3-month controlled , r and omised , double-blind clinical trial which involved 82 centres in France . Patients x : 277 out patients who met DSM-IV criteria for major depression . Interventions : Patients were treated with either tianeptine ( 12.5 mg three times daily ) or paroxetine ( 20 mg once daily plus two placebo capsules ) . The drug dosages could be doubled after 3 weeks if required by the patient ’s medical state . Main Outcome Measures and Results : There was a significant decrease in the Montgomery-Åsberg Depression Rating Scale score in both groups ( from 28.9 at baseline to 11 at endpoint in the tianeptine group , and from 29.6 to 11.6 in the paroxetine group ) after 3 months of treatment . No significant difference was evident between the groups . Secondary criteria confirmed the antidepressant efficacy of both medications , with no difference between tianeptine and paroxetine  ( Hamilton Depression Rating Scale global score at endpoint , Clinical Global Impression final scores , number of responders , delay-to-response , rate of dosage doubling at day 21 ) . The anxiolytic and hypnotic consumption rates decreased in both groups , with no significant difference between the groups . There was no significant difference in clinical safety parameters . Conclusion : Tianeptine appears to be as effective and as safe as paroxetine for the ambulatory treatment of major depression
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 .