title: Comparative efficacies of fluoxetine and paroxetine in major depression across varying acute-phase treatment periods: a meta-analysis.
abstract: BACKGROUND
  Previous studies have shown that varying acute-phase treatment periods of fluoxetine and paroxetine can result in varying antidepressive effects. We therefore did a meta-analysis to ascertain the efficacy of fluoxetine versus paroxetine for depression by varying acute-phase treatment periods.
  
  
  METHODS
  PubMed, CCTR, Web of Science, Embase, CBM-disc, and CNKI were searched up to March 2013. The key search terms were "depression," "paroxetine," and "fluoxetine." No language restriction was imposed.
  
  
  RESULTS
  We included 17 studies with 3,110 patients. Three treatment period subgroups were created: 6, 8/10, and 12 weeks. In the 6-week subgroup, paroxetine was more efficacious than fluoxetine (odds ratio [OR]: 0.74; P < 0.05). In the 8/10-week subgroup, two drugs displayed comparative efficacy (OR, 0.85; P > 0.05). In the 12-week subgroup, fluoxetine was more efficacious than paroxetine (OR: 1.25; P < 0.05). There were no significant differences in acceptability. Significant heterogeneity and potential publication bias did not exist.
  
  
  CONCLUSIONS
  Patients' economic conditions, individual preference, and side effects of fluoxetine and paroxetine can be obstacles of successful treatment. Inappropriate acute-phase treatment, such as inadequate treatment periods, may result in pseudoresistance. Clinicians should take these information into consideration when prescribe fluoxetine or paroxetine for patients. Our results can aid clinicians in making an optimal treatment plan to increase odds of response.
authors.affiliation: Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience, Chongqing Medical University, Chongqing, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Lehua
authors.initials: L
authors.lastname: Yu
authors.forename: Jing
authors.initials: J
authors.lastname: Xie
authors.forename: Jianjun
authors.initials: J
authors.lastname: Chen
authors.forename: Qianping
authors.initials: Q
authors.lastname: Wei
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D017374:Paroxetine / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors
keywords: depression; fluoxetine; meta-analysis; paroxetine; selective serotonin reuptake inhibitor