title: Treatment of major depressive disorders with generic duloxetine and paroxetine: a multi-centered, double-blind, double-dummy, randomized controlled clinical trial.
abstract: BACKGROUND
  This study is a pre-registration trial of generic duloxetine that was approved by the China Food and Drug Administration (approval number: 2006L01603).
  
  
  OBJECTIVE
  Compare the treatment efficacy and safety of generic duloxetine to that of paroxetine in patients with major depressive disorders (MDD).
  
  
  METHODS
  This was a double-dummy, double-blind, multicenter, positive drug (paroxetine), parallel randomized controlled clinical trial. The 299 patients with MDD recruited for the study were randomly assigned to use duloxetine (n=149; 40-60 mg/d) or paroxetine (n=150; 20 mg/d) for 8 weeks. The Hamilton Depression rating scale (HAMD-17) was administered at baseline and 1, 2, 4, 6, and 8 weeks after starting treatment. Remission was defined as a HAMD-17 score below 8 at the end of the trial, and treatment effectiveness was defined as a decrease in baseline HAMD-17 score of at least 50% by the end of the trial. Safety was assessed based on the reported prevalence and severity of side effects and changes in laboratory and electrocardiographic findings. Three patients in the duloxetine group dropped out before starting medication, so results were analyzed using a modified intention-to-treat (ITT) method with 146 in the experimental group and 150 in the control group.
  
  
  RESULTS
  Both groups experienced 29 dropouts during the 8-week trial. HAMD-17 scores decreased significantly from baseline throughout the trial in both groups. Based on the ITT analysis, at the end of the trial there was no significant difference between the duloxetine group and the paroxetine group in effectiveness (67.1% v. 71.3%, X(2)=0.62 p=0.433), remission rate (41.1% v. 51.3%, X(2)=3.12, p=0.077), or in the incidence of side effects (56.8% v. 54.7%, X(2)=0.14, p=0.705).
  
  
  CONCLUSIONS
  Generic duloxetine is as effective and safe as paroxetine in the acute treatment of patients with MDD who seek care at psychiatric outpatient departments in China.
authors.affiliation: Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China ; Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Zhiyang
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Psychiatry, First Affiliated Hospital, Kunming Medical College, Kunming, Yunnan Province, China.
authors.forename: Xiufeng
authors.initials: X
authors.lastname: Xu
authors.affiliation: Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
authors.forename: Qingrong
authors.initials: Q
authors.lastname: Tan
authors.affiliation: Hebei Mental Health Center, Baoding, Hebei Province, China.
authors.forename: Keqing
authors.initials: K
authors.lastname: Li
authors.affiliation: Guangzhou Brain Hospital, Guangzhou, Guangdong Province, China.
authors.forename: Cui
authors.initials: C
authors.lastname: Ma
authors.affiliation: Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
authors.forename: Shiping
authors.initials: S
authors.lastname: Xie
authors.affiliation: First Affiliated Hospital of Xi'an, Jiao Tong University Medical College, Xi'an, Shaanxi Province, China.
authors.forename: Chengge
authors.initials: C
authors.lastname: Gao
authors.affiliation: Beijing Anding Hospital, Capital Medical University, Beijing, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Huafang
authors.initials: H
authors.lastname: Li
keywords: China; duloxetine; efficacy; major depressive disorder; paroxetine; randomized controlled trial; safety