title: Specific Pharmacological Effects of Paroxetine Comprise Psychological but Not Somatic Symptoms of Depression.
abstract: BACKGROUND
  Meta-analyses of placebo-controlled trials of SSRIs suggest that only a small portion of the observable change in depression may be attributed to "true" pharmacological effects. But depression is a multidimensional construct, so treatment effects may differ by symptom cluster. We tested the hypothesis that SSRIs uniquely alter psychological rather than somatic symptoms of depression and anxiety.
  
  
  METHODS
  Outpatients with moderate to severe MDD were randomly assigned to receive paroxetine (n = 120) or placebo (n = 60).
  
  
  RESULTS
  Paroxetine significantly outperformed placebo on all psychological subscales of the syndrome measures, but not on any of the somatic subscales. The difference in score reduction between paroxetine and placebo was more than twice as great for the psychological symptoms compared to the somatic symptoms.
  
  
  CONCLUSIONS
  Paroxetine appears to have a "true" pharmacological effect on the psychological but not on the somatic symptoms of depression and anxiety. Paroxetine's influence on somatic symptoms appears to be mostly duplicated by placebo.
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Schalet
authors.affiliation: Department of Psychology, University of Pennsylvania, Philadelphia, PA, United States of America.
authors.forename: Tony Z
authors.initials: TZ
authors.lastname: Tang
authors.affiliation: Department of Psychology, University of Pennsylvania, Philadelphia, PA, United States of America.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: DeRubeis
authors.affiliation: Department of Psychology, Vanderbilt University, Nashville, TN, United States of America.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Hollon
authors.affiliation: Depression Research Unit, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America.
authors.forename: Jay D
authors.initials: JD
authors.lastname: Amsterdam
authors.affiliation: Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, AL, United States of America.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Shelton
mesh_terms: D001007:Anxiety / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D000071896:Medically Unexplained Symptoms; D009638:Norepinephrine / Q000378:metabolism; D017374:Paroxetine / Q000008:administration & dosage*; D010551:Personality; D011569:Psychiatric Status Rating Scales; D012701:Serotonin / Q000378:metabolism; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D009638:Norepinephrine; D017374:Paroxetine; D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors