title: Comparison of escitalopram and paroxetine in the treatment of major depressive disorder.
abstract: This is a single-blind, parallel, flexible-dose study to compare the efficacy and tolerability of escitalopram and paroxetine in the treatment of patients with major depressive disorder. We recruited 399 patients from the outpatient clinics of five hospitals in northern Taiwan. Patients were administered either escitalopram (10-30 mg) or paroxetine (20-40 mg) according to the judgment of clinicians. These patients were assessed using the Hamilton Rating Scale for Depression (HAM-D) and the Hamilton Rating Scale for Anxiety at weeks 0, 1, 2, 4, 6, and 8. A total of 302 patients fulfilled the evaluation criteria and were included in a statistical analysis. We found that escitalopram induced more significant symptom reduction and response rate in terms of the mean HAM-D scores at week 6 (P<0.05) and week 8 (P<0.05) than paroxetine, but that there were no significant differences between the two groups in the remission rate. Escitalopram induced significantly less frequency of adverse effects of weakness (P<0.01), nausea and vomiting (P<0.001), drowsiness (P<0.01) as well as somnolence (P<0.01) than paroxetine, although all these side effects were mild and tolerable. However for a more definitive result, future prospective trials with the inclusion of a placebo group and a double-blind design are needed. In patients who did not have severe depression (HAM-D score at baseline<21), but not in severely depressed patients, escitalopram was statistically superior to paroxetine, as shown by the mean change in the HAM-D score.
authors.affiliation: aCenter for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County bDepartment of Psychiatry, Chang-Gung Memorial Hospital and Chang-Gung University School of Medicine cDepartment of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University dDepartments of Psychiatry, Wan Fang Medical Center and School of Medicine, Taipei Medical University eDepartment of Psychiatry, Mackay Memorial Hospital fDepartment of Psychiatry, Songde Branch, Taipei City Hospital, Taipei gDepartment of Psychiatry, Shuang Ho Hospital, Taipei Medical University hDepartment of Psychiatry, Far Eastern Memorial Hospital, New Taipei City iDivision of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes jDivision of Clinical Trial Statistics, Institute of Population Health Sciences, National Health Research Institutes kDivision of Mental Health and Addiction Medicine, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County lGraduate Institute of Drug Safety, China Medical University, Taichung, Taiwan mDepartment of Psychiatry, UCLA, California, USA.
authors.forename: Huang-Li
authors.initials: HL
authors.lastname: Lin
authors.forename: Ya-Ting
authors.initials: YT
authors.lastname: Hsu
authors.forename: Chia-Yih
authors.initials: CY
authors.lastname: Liu
authors.forename: Chia-Hui
authors.initials: CH
authors.lastname: Chen
authors.forename: Mei-Chun
authors.initials: MC
authors.lastname: Hsiao
authors.forename: Yu-Li
authors.initials: YL
authors.lastname: Liu
authors.forename: Winston W
authors.initials: WW
authors.lastname: Shen
authors.forename: Chin-Fu
authors.initials: CF
authors.lastname: Hsiao
authors.forename: Shen-Ing
authors.initials: SI
authors.lastname: Liu
authors.forename: Liang-Huey
authors.initials: LH
authors.lastname: Chang
authors.forename: Hwa-Sheng
authors.initials: HS
authors.lastname: Tang
authors.forename: Hsiang-Ling
authors.initials: HL
authors.lastname: Lai
authors.forename: Pei-Sheng
authors.initials: PS
authors.lastname: Lin
authors.forename: Keh-Ming
authors.initials: KM
authors.lastname: Lin
authors.forename: Hsiao-Hui
authors.initials: HH
authors.lastname: Tsou
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D015283:Citalopram / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017374:Paroxetine / Q000627:therapeutic use*; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram; D017374:Paroxetine