Efficacy and tolerability of controlled-release and immediate-release paroxetine in the treatment of depression
by
Golden RN, Nemeroff CB, McSorley P, Pitts CD, Dube EM.
Department of Psychiatry,
University of North Carolina School of Medicine,
Chapel Hill 27599-7160, USA.
robert_golden@med.unc.edu
J Clin Psychiatry 2002 Jul;63(7):577-84


ABSTRACT

BACKGROUND: Antidepressant efficacy may be compromised by early discontinuation of treatment secondary to common, treatment-emergent side effects, including nausea, agitation, and somnolence. Paroxetine controlled-release (CR) was developed to improve general tolerability and, in particular, gastrointestinal tolerability. OBJECTIVE: To determine the antidepressant efficacy and tolerability of paroxetine CR in adult patients 18 to 65 years of age with DSM-IV major depressive disorder. METHOD: Paroxetine CR (25-62.5 mg/day; N = 212) and paroxetine immediate-release (IR; 20-50 mg/day; N = 217) were compared with placebo (N = 211) in the pooled dataset from 2 identical, double-blind, 12-week clinical trials. RESULTS: Both paroxetine CR and paroxetine IR exhibited efficacy in major depressive disorder as assessed by the reduction in 17-item Hamilton Rating Scale for Depression total score compared with placebo. Moreover, depressed mood and psychic anxiety symptoms improved as early as treatment week 1 in the paroxetine CR group compared with the placebo group. After 6 weeks of treatment, response and remission rates were 41.5% and 20.5% for placebo, 52.8% and 29.6% for paroxetine IR, and 58.9% and 34.4% for paroxetine CR, respectively. After 12 weeks of treatment, response and remission rates were 61.2% and 44.0% for placebo, 72.9% and 52.5% for paroxetine IR, and 73.7% and 56.2% for paroxetine CR, respectively. Rates of nausea were significantly lower for paroxetine CR (14%) than for paroxetine IR (23%; p < or = .05) during week 1. Rates of dropout due to adverse events were comparable between paroxetine CR and placebo, while significantly (p = .0008) more patients treated with paroxetine IR withdrew from the study prematurely compared with those treated with placebo. CONCLUSION: Paroxetine CR is an effective and well-tolerated antidepressant exhibiting symptomatic improvement as early as week 1. Paroxetine CR is associated with low rates of early-onset nausea and dropout rates due to adverse events comparable to those of placebo. The clinical improvement seen with paroxetine CR, coupled with its favorable adverse event profile, suggests a benefit for therapeutic outcome with paroxetine CR.
SSRIs
Anxiety
Serotonin
Paroxetine
Social phobia
Panic disorder
Paroxetine update
Paroxetine and suicide
Paroxetine v bupropion
Paroxetine v fluoxetine
Paroxetine v maprotiline
SSRIs and panic disorder
Antidepressant metabolism
Paroxetine and noradrenaline
Paroxetine (Paxil, Seroxat) : structure
Venlafaxine versus paroxetine for OCD
Paroxetine (Paxil), pain and the opioid system
Does early improvement predict later stable response?
How effective are commonly prescribed antidepressants?
Paroxetine: systematic re-examination of published and unpublished data


Refs
and further reading

HOME
HedWeb
Nootropics
erythroxylum-coca.com
Future Opioids
BLTC Research
MDMA/Ecstasy
Superhapiness?
Utopian Surgery?
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
Critique of Huxley's Brave New World

The Good Drug Guide
The Good Drug Guide

The Responsible Parent's Guide
To Healthy Mood Boosters For All The Family