title: Factors affecting discontinuation of initial treatment with paroxetine in panic disorder and major depressive disorder.
abstract: OBJECTIVE
  The aims of the present study were to analyze the association between discontinuation of paroxetine (PAX) and the genetic variants of the polymorphism in the serotonin transporter gene-linked polymorphic region (5-HTTLPR) in Japanese patients with panic disorder (PD) and major depressive disorder (MDD).
  
  
  METHODS
  The 5-HTTLPR genotype was determined by polymerase chain reaction method. PAX plasma concentration was measured by high-performance liquid chromatography to confirm adherence.
  
  
  RESULTS
  When comparing between the PD and MDD patients with the chi-square test and Fisher's exact test, the PD patients had a significant and higher discontinuation rate due to non-adherence than did the MDD patients (13.5% [7/52] versus 0% [0/88], respectively; P<0.001). MDD patients had a significant and higher discontinuation rate due to untraceability than PD patients (12.5% [11/88] versus 1.9% [1/52]; P=0.032). Multilogistic regression revealed a tendency for the long/short and short/short genotypes to affect discontinuation due to adverse effects in PD patients (25.0% versus 6.3%, respectively; P=0.054).
  
  
  CONCLUSIONS
  The results indicate that the 5-HTTLPR genotype might contribute to the discontinuation of initial PAX treatment due to adverse effects in PD patients.
authors.affiliation: Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Aoki
authors.affiliation: Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Ishiguro
authors.affiliation: Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Mikito
authors.initials: M
authors.lastname: Ueda
authors.affiliation: Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Akiyama
authors.affiliation: Sakura La Mental Clinic, Tochigi, Japan.
authors.forename: Kazuko
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Aomori, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Tsuchimine
authors.affiliation: Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Aomori, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Yasui-Furukori
authors.affiliation: Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Shimoda
keywords: discontinuation; major depressive disorder; panic disorder; paroxetine