Paroxetine Versus Venlafaxine and Escitalopram in Korean Patients with Major Depressive Disorder: A Randomized, Rater-blinded, Six-week Study
Overview
Authors
Affiliations
Objective: The purpose of this study was to compare the efficacy and safety of escitalopram, paroxetine and venlafaxine in Korean patients with major depressive disorder (MDD).
Methods: A total of 449 Korean MDD patients were recruited in a six-week, randomized, rater-blinded, active-controlled trial and were evenly randomized to paroxetine, venlafaxine, or escitalopram treatment.
Results: When comparing the mean difference for the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating Scale (HDRS) total scores during six weeks, paroxetine (-6.4±0.4, and -5.4±0.4, respectively) was found to be significantly superior to escitalopram (-3.7±0.5 and -3.1±0.4, respectively). Venlafaxine had a significantly lower MADRS total score (-5.4±0.4) than escitalopram. When adjusting baseline variables, the response, according to the MADRS and HDRS scores, in the paroxetine group was greater than that for the escitalopram group (odds ratio [OR]=2.43, 95% confidence interval [CI]=1.42-4.16 for MADRS; and OR=2.32, 95% CI=1.35-3.97 for HDRS) and the venlafaxine group (OR=1.94, 95% CI=1.17-3.21 for MADRS; and OR=1.71, 95% CI=1.03-2.83 for HDRS). Despite that the overall tolerability was high and similar among the three groups, a total of 268 subjects (59.7%) prematurely discontinued treatment, representing the main limitation of the present study.
Conclusion: Although a low study completion rate limits generalizability, our findings suggest that paroxetine might be superior to escitalopram in Korean MDD patients. Further studies should be conducted to draw a definite conclusion.
Wang Z, Li H, Kang Y, Liu Y, Shan L, Wang F Ther Clin Risk Manag. 2022; 18:799-812.
PMID: 35992228 PMC: 9386738. DOI: 10.2147/TCRM.S363404.
Tolahunase M, Sagar R, Dada R Indian J Psychiatry. 2018; 60(4):410-426.
PMID: 30581206 PMC: 6278208. DOI: 10.4103/psychiatry.IndianJPsychiatry_398_17.