title: Escitalopram versus paroxetine controlled release in major depressive disorder: a randomized trial.
abstract: OBJECTIVE
  There are no direct comparisons between escitalopram and paroxetine controlled release in patients with major depressive disorder (MDD).
  
  
  METHODS
  We conducted a 24-week, rater-masked, randomized trial of escitalopram (5-20 mg/day) versus paroxetine controlled release (12.5-50 mg/day) in patients with MDD (UMIN000011191). Patients with the diagnosis of moderate-to-severe MDD (a 17-item Hamilton Rating Scale for Depression [HAMD-17], with total score at baseline being ≥20) were recruited to participate in a parallel, randomized, controlled trial. The primary outcome for efficacy was an improvement in the 21-item HAMD (HAMD-21) total score at 24 weeks. The secondary outcomes were the response, remission, and discontinuation rates and the incidence of individual adverse events.
  
  
  RESULTS
  A total of 88 patients with MDD (males, 61.4%; mean age, 40.8±13.4 years) were recruited. The discontinuation rate was 58.0% (escitalopram, 55.8%; paroxetine controlled release, 60.0%). Both escitalopram and paroxetine controlled-release treatment groups exhibited significant reduction in the HAMD-21 total score at 2, 4, 8, 12, and 24 weeks from the baseline. However, there were no significant differences in the HAMD-21 total score, response rate, remission rate, and discontinuation rate at any time point between the groups. In addition, there were no significant differences in the incidence of any individual adverse events (eg, nausea, vomiting, and somnolence) between the treatment groups.
  
  
  CONCLUSIONS
  Our results suggest that escitalopram and paroxetine controlled release had similar efficacy and safety profiles in patients with MDD. One of the primary limitations of this study is the small sample size.
authors.affiliation: Department of Psychiatry, Fujita Health University School of Medicine.
authors.forename: Taro
authors.initials: T
authors.lastname: Kishi
authors.affiliation: Department of Psychiatry, Fujita Health University School of Medicine.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Matsuda
authors.affiliation: Department of Psychiatry, Fujita Health University School of Medicine.
authors.forename: Shinji
authors.initials: S
authors.lastname: Matsunaga
authors.affiliation: Department of Psychiatry, Fujita Health University School of Medicine; Department of Psychiatry, Okehazama Hospital, Toyoake.
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Moriwaki
authors.affiliation: Department of Psychiatry, Okehazama Hospital, Toyoake.
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Otake
authors.affiliation: Department of Psychiatry, Jindai Clinic, Nagoya.
authors.forename: Kaku
authors.initials: K
authors.lastname: Akamatsu
authors.affiliation: Department of Psychiatry, Toyota Memorial Hospital.
authors.forename: Tomo
authors.initials: T
authors.lastname: Okochi
authors.affiliation: Department of Psychiatry, Toyota Memorial Hospital.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Hirano
authors.affiliation: Department of Psychiatry, Jindai Hospital, Toyota, Aichi.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Funahashi
authors.affiliation: Department of Psychiatry, Holy Cross Hospital, Toki, Gifu, Japan.
authors.forename: Momoko
authors.initials: M
authors.lastname: Okuda
authors.affiliation: Department of Psychiatry, Holy Cross Hospital, Toki, Gifu, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tabuse
authors.affiliation: Department of Psychiatry, Okehazama Hospital, Toyoake.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Fujita
authors.affiliation: Department of Psychiatry, Fujita Health University School of Medicine.
authors.forename: Nakao
authors.initials: N
authors.lastname: Iwata
keywords: Hamilton Rating Scale for Depression; antidepressant; escitalopram; major depressive disorder; paroxetine controlled release