Display options
Share it on

CNS Drugs. 2002;16(6):425-34. doi: 10.2165/00023210-200216060-00006.

Spotlight on paroxetine in psychiatric disorders in adults.

CNS drugs

Antona J Wagstaff, Susan M Cheer, Anna J Matheson, Douglas Ormrod, Karen L Goa

Affiliations

  1. Adis International Limited, Auckland, New Zealand. [email protected]

PMID: 12027788 DOI: 10.2165/00023210-200216060-00006

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.

References

  1. Breast Cancer Res Treat. 2001 Nov;70(1):1-10 - PubMed
  2. Acta Psychiatr Scand. 1997 Feb;95(2):145-52 - PubMed
  3. Am J Psychiatry. 1998 Mar;155(3):367-72 - PubMed
  4. Br J Psychiatry. 1999 Aug;175:120-6 - PubMed
  5. J Clin Psychopharmacol. 1999 Apr;19(2):164-71 - PubMed
  6. Pharmacopsychiatry. 2001 May;34(3):85-90 - PubMed
  7. J Clin Psychopharmacol. 1997 Aug;17(4):267-71 - PubMed
  8. Acta Psychiatr Scand. 1988 Jun;77(6):683-8 - PubMed
  9. Acta Psychiatr Scand Suppl. 1989;350:85-6 - PubMed
  10. Am J Psychiatry. 1998 Oct;155(10):1346-51 - PubMed
  11. J Clin Psychiatry. 2001;62 Suppl 3:10-21 - PubMed
  12. Psychopharmacology (Berl). 1996 Jul;126(1):50-4 - PubMed
  13. J Clin Psychiatry. 2001 Nov;62(11):860-8 - PubMed
  14. Drugs. 1998 Jan;55(1):85-120 - PubMed
  15. Acta Psychiatr Scand Suppl. 1989;350:60-75 - PubMed
  16. Pharmacopsychiatry. 1997 May;30(3):97-105 - PubMed
  17. J Clin Psychiatry. 1992 Feb;53 Suppl:48-51 - PubMed
  18. Int Clin Psychopharmacol. 1992 Jun;6 Suppl 4:37-41 - PubMed
  19. Psychopharmacol Bull. 1990;26(2):185-9 - PubMed
  20. Am J Psychiatry. 1998 Jan;155(1):36-42 - PubMed
  21. J Rheumatol. 2000 Dec;27(12):2791-7 - PubMed
  22. J Affect Disord. 2000 Aug;59(2):119-26 - PubMed
  23. Acta Psychiatr Scand. 1992 Dec;86(6):437-44 - PubMed
  24. Am J Psychiatry. 1999 Jul;156(7):1024-8 - PubMed
  25. Pharmacopsychiatry. 1993 May;26(3):75-8 - PubMed
  26. J Affect Disord. 1993 Jun;28(2):71-9 - PubMed
  27. Br J Psychiatry. 1996 Oct;169(4):468-74 - PubMed
  28. J Clin Psychopharmacol. 1993 Dec;13(6 Suppl 2):18S-22S - PubMed
  29. Int Clin Psychopharmacol. 1997 Jan;12(1):13-8 - PubMed
  30. Acta Psychiatr Scand. 1997 Feb;95(2):153-60 - PubMed
  31. Arch Gen Psychiatry. 2000 Sep;57(9):875-82 - PubMed
  32. Ann Clin Psychiatry. 1998 Dec;10(4):145-50 - PubMed
  33. Int Clin Psychopharmacol. 2001 May;16(3):169-78 - PubMed
  34. Am J Psychiatry. 2001 Dec;158(12):1982-8 - PubMed
  35. J Clin Psychiatry. 1992 Feb;53 Suppl:52-6 - PubMed
  36. JAMA. 1998 Aug 26;280(8):708-13 - PubMed
  37. Hum Psychopharmacol. 2001 Apr;16(3):219-227 - PubMed
  38. J Clin Psychiatry. 1992 Feb;53 Suppl:40-3 - PubMed
  39. Br J Psychiatry. 1991 Sep;159:394-8 - PubMed
  40. J Psychopharmacol. 1997;11(1):72-82 - PubMed
  41. Acta Psychiatr Scand Suppl. 1989;350:91-2 - PubMed
  42. J Fam Pract. 2001 May;50(5):405-12 - PubMed
  43. N Engl J Med. 2001 Mar 29;344(13):961-6 - PubMed
  44. J Clin Psychiatry. 1996;57 Suppl 2:46-52 - PubMed
  45. Br J Psychiatry. 1995 Sep;167(3):374-9 - PubMed
  46. J Clin Psychopharmacol. 2000 Apr;20(2):137-40 - PubMed
  47. Psychopharmacology (Berl). 1995 Jun;119(3):277-81 - PubMed
  48. J Clin Psychiatry. 1999 Dec;60(12):831-8 - PubMed
  49. Depress Anxiety. 2000;11(3):99-104 - PubMed
  50. J Clin Psychiatry. 1999;60 Suppl 20:16-20 - PubMed
  51. Acta Psychiatr Scand. 1993 May;87(5):302-5 - PubMed
  52. S Afr Med J. 1999 Apr;89(4):402-6 - PubMed
  53. Eur Neuropsychopharmacol. 1998 Dec;8(4):273-8 - PubMed
  54. Br J Clin Pract. 1996 Jul-Aug;50(5):240-4 - PubMed
  55. J Clin Psychopharmacol. 1993 Dec;13(6 Suppl 2):34S-39S - PubMed
  56. Acta Psychiatr Scand. 1993 Feb;87(2):141-5 - PubMed
  57. J Clin Psychopharmacol. 1994 Aug;14(4):241-6 - PubMed
  58. J Clin Psychopharmacol. 2000 Dec;20(6):645-52 - PubMed
  59. J Clin Psychiatry. 1997 Mar;58(3):112-8 - PubMed
  60. Acta Psychiatr Scand. 1999 Sep;100(3):193-8 - PubMed
  61. J Affect Disord. 1999 Jul;54(1-2):39-48 - PubMed
  62. J Clin Psychiatry. 2001 May;62(5):350-7 - PubMed
  63. Acta Psychiatr Scand Suppl. 1989;350:132-4 - PubMed
  64. Int J Geriatr Psychiatry. 1998 Feb;13(2):100-8 - PubMed
  65. Int Clin Psychopharmacol. 1993 Fall;8(3):189-95 - PubMed
  66. Int Clin Psychopharmacol. 1997 Mar;12(2):81-9 - PubMed
  67. Acta Psychiatr Scand. 1996 Mar;93(3):158-63 - PubMed
  68. Clin Pharmacokinet. 1995;29 Suppl 1:1-9 - PubMed
  69. Acta Psychiatr Scand Suppl. 1989;350:89-90 - PubMed
  70. Acta Psychiatr Scand. 1997 May;95(5):444-50 - PubMed
  71. JAMA. 2000 Sep 27;284(12):1519-26 - PubMed
  72. J Clin Psychiatry. 1992 Feb;53 Suppl:57-60 - PubMed
  73. J Clin Psychopharmacol. 1993 Dec;13(6 Suppl 2):23S-27S - PubMed
  74. Int Clin Psychopharmacol. 1992 Jun;6 Suppl 4:59-64 - PubMed
  75. J Clin Psychiatry. 1997 Apr;58(4):146-52 - PubMed

Substances

MeSH terms

Publication Types