Abstract
A double-blind comparison of paroxetine and maprotiline was undertaken involving both out and in patients presenting with DSMIIIR major depression who achieved a minimum score of 18 points on the 21-item Hamilton Depression Rating Scale (HAMD) at baseline. After a 7 day placebo washout period, patients were randomly allocated to receive paroxetine 20-40mg/d or maprotiline 50-150mg/d, the dose being titrated according to clinical response. Assessments conducted at baseline (day 0) and at the end of weeks 1,3 and 6 included the 21-item HAMD, the Montgomery-Asberg Depression Rating Scale (MADRS) and the CGI. Adverse events were elicited via non-leading questioning. 131 patients (65 paroxetine and 66 maprotiline) were evaluable on an intent to treat basis. The two groups were demographically well matched and demonstrated comparable antidepressant response as evidenced by HAMD MADRS and CGI scores; Adverse events were reported by 57% paroxetine and 67% maprotiline treated patients. Anticholinergic events, were reported by 19% paroxetine and 41% maprotiline treated patients (p=0.007). Twelve patients (6 paroxetine, 6 maprotiline) were withdrawn from the study due to adverse events. This study further confirms the efficacy of paroxetine in the treatment of major depression. Significantly more anticholinergic events were reported for maprotiline suggesting a tolerability advantage for paroxetine.
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Kasas, A., Reynaert, C., Laruelle, M. et al. A double-blind study of paroxetine and maprotiline in major depression. Neuropsychopharmacol 11, 274 (1994). https://doi.org/10.1038/sj.npp.1380171
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DOI: https://doi.org/10.1038/sj.npp.1380171