Paroxetine: an update of its use in psychiatric disorders in adults.

Full Abstract

Paroxetine is a selective serotonin reuptake inhibitor (SSRI), with antidepressant and anxiolytic activity. In 6- to 24-week well designed trials, oral paroxetine 10 to 50 mg/day was significantly more effective than placebo, at least as effective as tricyclic antidepressants (TCAs) and as effective as other SSRIs and other antidepressants in the treatment of major depressive disorder. Relapse or recurrence over 1 year after the initial response was significantly lower with paroxetine 10 to 50 mg/day than with placebo and similar to that with imipramine 50 to 275 mg/day. The efficacy of paroxetine 10 to 40 mg/day was similar to that of TCAs and fluoxetine 20 to 60 mg/day in 6- to 12-week trials in patients aged > or =60 years with major depression. Paroxetine 10 to 40 mg/day improved depressive symptoms to an extent similar to that of TCAs in patients with comorbid illness, and was more effective than placebo in the treatment of dysthymia and minor depression. Paroxetine 20 to 60 mg/day was more effective than placebo after 8 to 12 weeks' treatment of obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder (social phobia), generalised anxiety disorder (GAD) and post-traumatic stress disorder (PTSD). Improvement was maintained or relapse was prevented for 24 weeks to 1 year in patients with OCD, panic disorder, social anxiety disorder or GAD. The efficacy of paroxetine was similar to that of other SSRIs in patients with OCD and panic disorder and similar to that of imipramine but greater than that of 2'chlordesmethyldiazepam in patients with GAD. Paroxetine is generally well tolerated in adults, elderly individuals and patients with comorbid illness, with a tolerability profile similar to that of other SSRIs. The most common adverse events with paroxetine were nausea, sexual dysfunction, somnolence, asthenia, headache, constipation, dizziness, sweating, tremor and decreased appetite. In conclusion, paroxetine, in common with other SSRIs, is generally better tolerated than TCAs and is a first-line treatment option for major depressive disorder, dysthymia or minor depression. Like other SSRIs, paroxetine is also an appropriate first-line therapy for OCD, panic disorder, social anxiety disorder, GAD and PTSD. Notably, paroxetine is the only SSRI currently approved for the treatment of social anxiety disorder and GAD, which makes it the only drug of its class indicated for all five anxiety disorders in addition to major depressive disorder. Thus, given the high degree of psychiatric comorbidity of depression and anxiety, paroxetine is an important first-line option for the treatment of major depressive disorder, OCD, panic disorder, social anxiety disorder, GAD and PTSD.

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Author information

Author/s: Wagstaff, Antona J (AJ); Cheer, Susan M (SM); Matheson, Anna J (AJ); Ormrod, Douglas (D); Goa, Karen L (KL);

Affiliation: Adis International Limited, Auckland, New Zealand. demail(-atsign-)adis.co.nz

Journal and publication information

Publication Type: Journal Article; Review

Journal: Drugs (Drugs), published in New Zealand. (Language: eng)

Reference: 2002-; vol 62 (issue 4) : pp 655-703

Dates: Created 2002/03/14; Completed 2002/04/23; Revised 2007/11/15;

PMID: 11893234, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

ErratumIn: Drugs 2002;62(10):1461.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Administration, Oral
Adult
Aged
Antidepressive Agents, Second-Generation - pharmacokinetics; therapeutic use
Clinical Trials as Topic
Comorbidity
Half-Life

Humans
Intestinal Absorption
Mental Disorders - drug therapy
Middle Aged
Paroxetine - metabolism; pharmacokinetics; therapeutic use
Psychomotor Performance - drug effects
Treatment Outcome

Associated Chemicals: Antidepressive Agents, Second-Generation (0) ; Paroxetine (61869-08-7)

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