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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a meta-analysis of ten studies in elderly patients, paroxetine (n = 387) was as effective an antidepressant as active controls (amitriptyline n = 110; clomipramine n = 109; doxepin n = 102; mianserin n = 28). The change over 5-6 weeks of therapy, on the Hamilton Depression Rating Scale, was significantly better with paroxetine compared with active controls. A similar advantage was seen when the responder rate was considered. Adverse events were less frequent and less severe with paroxetine treatment, especially anticholinergic adverse events. Paroxetine was effective in treating anxiety symptoms associated with depression, yet caused significantly less sedation compared with active controls. There was little difference in the overall safety profiles seen between the paroxetine and active control groups. However, data are available indicating reduced cardiotoxicity for paroxetine and a beneficial effect on suicidal thoughts. Overall, the results indicate paroxetine is an alternative first-line therapy to these older antidepressants and should be considered when treating elderly patients.
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PMID:Paroxetine in the elderly: a comparative meta-analysis against standard antidepressant pharmacotherapy. 750 98

[3H]Paroxetine is a more reliable ligand for studying the serotonin (5-HT) transporter complex than [3H]imipramine. The present study investigates [3H]paroxetine binding to platelets in 54 depressed in-patients (18 minor, 16 simple major and 20 melancholic depressed patients) and 16 healthy controls. There were no significant differences in maximal number of binding sites between depressed subjects and normal controls. There was no correlation between [3H]paroxetine binding to platelet membranes and severity of depression. [3H]Paroxetine binding to platelets was significantly higher in spring than in summer, fall and winter.
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PMID:Binding of [3H]paroxetine to platelets of depressed patients: seasonal differences and effects of diagnostic classification. 779 64

The SSRIs are a new class of effective antidepressant agents which have proven efficacy in a wide range of psychiatric applications. They are as effective as the tricyclic antidepressants and are better tolerated. The SSRIs are safe in overdose and have minimal drug interactions, and are suitable for once-daily dosing. Newer members of the class, such as paroxetine, have shorter half-lives and no active metabolites, and are likely to be safer than other members of the class. Paroxetine has been compared with the standard tricyclic antidepressants in a range of studies, and the efficacy and tolerability data from these studies have been collected together in the worldwide database on paroxetine. Paroxetine was shown to be at least as effective as active comparators in melancholic depression (DSM-III). In a comparative study of paroxetine and fluoxetine, both drugs were effective in reducing depressive symptoms and paroxetine showed a faster onset of action than fluoxetine. A higher incidence of side-effects was obtained in fluoxetine patients. In a long-term comparative study of paroxetine and placebo, fewer patients relapsed while on paroxetine for one year than on placebo--15 and 38%, respectively.
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PMID:[Clinical effects of serotonin reuptake inhibitors--a review]. 795 28

Paroxetine is a novel phenylpiperidine compound that is a potent and selective serotonin reuptake inhibitor. It has little affinity for alpha-adrenergic, dopamine, histamine, and cholinergic receptors. The pharmacokinetic properties of paroxetine are well suited to clinical use. Its bioavailability is not affected by food or antacids; its mean half-life of about 24 hours is consistent with once-a-day dosing; also, it has no pharmacologically active metabolites. In clinical studies involving over 6,700 patients worldwide, the efficacy of paroxetine has been shown consistently to be superior to placebo and comparable to tricyclic antidepressant agents in the treatment of depression. During these trials, paroxetine was used in a broad range of depressed patients, including the moderately to severely depressed, the elderly, and patients whose depressions were accompanied by symptoms of anxiety. In addition, it has been shown to be effective for the prevention of depressive relapse during long-term treatment. Side effects associated with paroxetine tend to be relatively mild, transient, and easily managed. As with other selective serotonin reuptake inhibitors, the most common side effect associated with paroxetine treatment is nausea, although this effect rarely leads to dose reduction or drug discontinuation. Paroxetine should not be coadministered with monoamine oxidase inhibitors or L-tryptophan. Animal data and limited clinical experience suggest that paroxetine is considerably safer in overdose than are tricyclic antidepressant drugs.
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PMID:Paroxetine: an overview of the efficacy and safety of a new selective serotonin reuptake inhibitor in the treatment of depression. 810 49

Paroxetine is a novel phenylpiperidine antidepressant agent that acts as a potent and selective inhibitor of serotonin reuptake. We report results of a 6-week, randomized, double-blind, multicenter study comparing paroxetine and fluoxetine in the treatment of major depression. One hundred seventy-eight inpatients, who met DSM-III-R criteria for a major depressive episode and had a Montgomery Asberg Depression Rating Scale (MADRS) score of 24 or more, were included in the study. Their ages ranged from 18 to 65 years. Subjects were randomized to receive either paroxetine or fluoxetine for 6 weeks. A 20-mg fixed dose, given once daily in the morning, was used for both drugs. After baseline, regular assessments were made at the end of weeks 1, 2, 3, 4, and 6. Efficacy measures included the MADRS, the Clinical Global Impression severity of illness scale, the Hamilton Rating Scale for Anxiety, the Hospital Anxiety and Depression scale, and the Visual Analogue Scale for anxiety. Safety and tolerability were assessed by adverse event reports, clinical examinations, vital signs, and laboratory data. A marked antidepressant response and good tolerability were seen with both drugs. These results further support the usefulness of paroxetine in the treatment of depressive illness.
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PMID:A double-blind, randomized, fluoxetine-controlled, multicenter study of paroxetine in the treatment of depression. 810 50

The efficacy of paroxetine and fluoxetine and their effects on cognitive and behavioural function were compared in a 6 week, double-blind, randomized study of 106 elderly depressed patients (aged 61 to 85 years). Antidepressant efficacy was assessed using the Hamilton depression rating scale (HAMD), Montgomery-Asberg Depression Rating Scale (MADRS) and Clinical Global Impression (CGI) scale. The Sandoz Clinical Assessment Geriatric scale (SCAG), the Mini-Mental State Examination (MMSE), and HAMD cognitive factor scores were used to assess cognitive and behavioural function. Paroxetine demonstrated comparable efficacy to fluoxetine in the treatment of elderly depressed patients, but at the end of treatment, there was a significantly higher proportion of responders to paroxetine than to fluoxetine. Both treatments produced improvements in all measures of cognitive and behavioural function, but paroxetine was significantly superior to fluoxetine from Week 3, indicating a possible early effect. There was no difference between the two agents in either the tolerability or safety of treatment.
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PMID:Paroxetine in the elderly depressed patient: randomized comparison with fluoxetine of efficacy, cognitive and behavioural effects. 819 78

Major depression afflicts a significant percentage of the population, and optimum therapy is often limited by the poor tolerability and lethality in overdose of the tricyclic antidepressants. The selective serotonin reuptake inhibitors (SSRIs) fluoxetine, sertraline, and, more recently, paroxetine are viewed as welcome additions to existing therapy. The SSRIs are as effective as the tricyclic antidepressants, but are not associated with their adverse effect profile. Paroxetine in dosages of 20-50 mg/day is as effective as the older classic antidepressants, including amitriptyline, imipramine, and doxepin. It is effective in the elderly and in patients with recurrent, resistant, or severe depression.
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PMID:The clinical pharmacology and use of paroxetine, a new selective serotonin reuptake inhibitor. 819 30

In an investigation of the efficacy of paroxetine in relapse prevention and prophylaxis of depression, patients who met DSM-III-R criteria for major depression with a history of two or more previous episodes in the preceding four years and who had responded to eight weeks treatment with paroxetine, were randomized double-blind to receive either paroxetine 20-30 mg or placebo for one year. One hundred and seventy-two patients entered open treatment of whom 141 completed eight weeks treatment. One hundred and thirty-five responders entered the double-blind placebo-controlled study. There was a significant advantage for paroxetine compared with placebo in the reappearance of depression (p < 0.01) and in the time to reappearance (p < 0.001) over the one-year study. A significant advantage was seen for paroxetine compared with placebo in the first four months in relapse prevention (p < 0.01) and in the time to relapse (p < 0.005), and in the later period of treatment in preventing recurrence in the time to recurrence (p < 0.05). Paroxetine was effective in preventing the reappearance of depression following an acute illness. These results confirm the benefit of long-term pharmacotherapy for treating depressive illness.
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PMID:Paroxetine is better than placebo in relapse prevention and the prophylaxis of recurrent depression. 826 17

Paroxetine is a selective serotonin reuptake inhibitor effective in a once-daily administration regimen in the treatment of depression. In elderly patients (aged > or = 60 years) with major depression, short term (6 weeks) treatment with paroxetine produces clinical improvements significantly superior to those seen with placebo and similar to those with tricyclic antidepressant agents, mianserin and fluoxetine. There is evidence that paroxetine has positive effects on co-existing anxiety and does not precipitate agitation. Paroxetine has also shown potential in the symptomatic treatment of diabetic neuropathy; however, further clinical experience is needed to confirm this preliminary result. Short term paroxetine therapy is associated with fewer anticholinergic and CNS adverse effects, but generally more gastrointestinal disturbances, than tricyclic antidepressants and mianserin. Unlike the tricyclic agents, paroxetine does not significantly affect cardiovascular function or impair psychomotor performance. This tolerability profile should be particularly beneficial in elderly patients, who are generally more susceptible than younger patients to the anticholinergic and CNS adverse events associated with tricyclic antidepressant drugs, and in whom there is a higher prevalence of pre-existing cardiovascular disease. It also suggests an important potential advantage over tricyclic antidepressants in the setting of overdosage. Thus, primarily because of its better tolerability profile and potentially lower toxicity in overdosage and in patients with cardiovascular disease, paroxetine appears to be a more attractive option than tricyclic antidepressants for the treatment of depression in late life. Future research should attempt to define more fully the efficacy of paroxetine as long term prophylactic therapy for recurrent depression and to assess how its overall therapeutic profile compares with other selective serotonin reuptake inhibitors in the elderly.
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PMID:Paroxetine. A review of its pharmacology, therapeutic use in depression and therapeutic potential in diabetic neuropathy. 832 1

These data provide evidence for the antidepressant efficacy of paroxetine. Paroxetine- and imipramine-treated patients were significantly different from placebo-treated patients, but little different to each other, on all depressive outcome measures. However, paroxetine appeared to have a possibly greater and earlier beneficial effect on anxiety symptoms associated with depression, when compared with imipramine. Both active therapies were effective in treating patients with severe depression. Side effects for paroxetine were typical of other serotonin (5-HT) uptake inhibitors but different from those of imipramine. In particular, anticholinergic and cardiovascular symptoms were reduced, and premature withdrawal less likely.
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PMID:A study comparing paroxetine placebo and imipramine in depressed patients. 835 71


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