Paroxetine versus other anti‐depressive agents for depression

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Some possibly meaningful differences between paroxetine and other antidepressants exist, but no definitive conclusions can be drawn due to the limited number of studies per comparison.

Major depression is a severe mental illness characterised by a persistent and unreactive low mood and loss of all interest and pleasure, usually accompanied by a range of symptoms. Although medication and psychological treatments are both effective for major depression, antidepressant drugs remain the mainstay of treatment. Paroxetine is the most potent inhibitor of the reuptake of serotonin of all selective serotonin reuptake inhibitors (SSRIs). This review aimed to determine the efficacy, review the acceptability and investigate the adverse effects of paroxetine in comparison with other antidepressants.  One hundred and fifteen randomised controlled trials were included in this review, with a total of 26,134 participants. Paroxetine was more effective than reboxetine at increasing patients who responded early to treatment but less effective than mirtazapine (in the one to four weeks follow‐up) and probably citalopram (at six weeks follow‐up). There was some evidence that paroxetine is less well tolerated than agomelatine and St John’s Wort, as more patients allocated to paroxetine experienced at least some side effects. Most of included studies were sponsored by the drug industry, who may have overestimated the effect of paroxetine. Therefore, the results of this review should be interpreted with caution.

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