Research and Clinical Trials on Paroxetine (Paxil, Seroxat, Deroxat)

By Dr Greg Mulhauser
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This list of current clinical research trials on Paroxetine (Paxil, Seroxat, Deroxat) is followed by a short set of abstracts from the most recent research articles published on the drug.

Article Contents

Paroxetine (Paxil, Seroxat, Deroxat) Clinical Research Trials

From our searchable database at ClinicalTrialsFeeds.org, this list includes all the latest information about clinical trials involving Paroxetine (Paxil, Seroxat, Deroxat).

 

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Current Research Literature on Paroxetine (Paxil, Seroxat, Deroxat)

Here are abstracts for some of the latest research articles to have appeared on Paroxetine (Paxil, Seroxat, Deroxat):

Discriminative stimulus properties of the "atypical" antidepressant, mirtazapine, in rats: a pharmacological characterization.

Psychopharmacology (Berl). 2008 Aug 16;
Dekeyne A, Millan MJ
RATIONALE: Though interoceptive properties of antidepressants have been described, discriminative stimulus (DS) properties of mirtazapine, which does not affect monoamine reuptake, remain uncharacterized. OBJECTIVES: The objectives of the study are to train rats to recognize a mirtazapine DS, then perform substitution studies with other antidepressants and drugs acting at sites occupied by mirtazapine. MATERIALS AND METHODS: Using a two-lever, fixed-ratio 10 schedule, rats were trained to discriminate mirtazapine (2.5 mg/kg, i.p.) from saline. RESULTS: Sessions, 63 +/- 8, were necessary to reach the criterion for 14 rats that all subsequently recognized (100%) mirtazapine at the training dose. Mirtazapine blocks serotonin (5-HT)(2C) receptors, and the 5-HT(2C) antagonists, SB242,084, SB243,213 and S32006, revealed dose-dependent and full (>/=80%) substitution at doses of 2.5, 2.5, and 0.63 mg/kg, respectively. By contrast, the 5-HT(2A) antagonists, MDL100,907 and SR46349-B, the 5-HT(2B) antagonist, SB204,741, and the 5-HT(3) antagonist, ondansetron, showed no significant substitution. Though mirtazapine indirectly recruits 5-HT(1A) receptors, the 5-HT(1A) agonists, buspirone and 8-OH-DPAT, did not substitute. Mirtazapine blocks alpha(2)-adrenoceptors, but several alpha(2)-adrenoceptor antagonists (yohimbine, RX821,002 and atipamezole) failed to substitute. Despite blockade by mirtazapine of histamine H(1) receptors, no substitution was seen with the selective H(1) antagonist, pyrilamine. Finally, the selective noradrenaline reuptake inhibitor, reboxetine (0.16), fully substituted for mirtazapine, whereas the 5-HT/noradrenaline reuptake inhibitors, duloxetine and S33005, several 5-HT reuptake inhibitors (citalopram, fluvoxamine, and paroxetine) and the dopamine reuptake inhibitors, bupropion and GBR12,935, did not substitute. CONCLUSION: Mirtazapine elicits a DS in rats for which selective antagonists at 5-HT(2C) receptors display dose-dependent substitution, whereas drugs acting at other sites recognized by mirtazapine are ineffective.

Selective serotonin re-uptake inhibitor warnings and trends in exposures reported to poison control centres in Texas.

Public Health. 2008 Aug 13;
Forrester MB
OBJECTIVES: Since January 2002, the US Food and Drug Administration (FDA) has issued a number of advisories about the use of antidepressants, including selective serotonin re-uptake inhibitors (SSRIs). These advisories may have influenced the number of SSRI exposures reported to poison control centres. The purpose of this study was to examine time trends in SSRI exposures reported to poison control centres in Texas with respect to the timing of the various advisories. STUDY DESIGN: Retrospective review of data from poison control centres. METHODS: Cases were divided into two groups: (1) paroxetine exposures and (2) other SSRI exposures reported to poison control centres in Texas between 1998 and 2006. The month and year of the call, and patient age and gender were identified. The mean monthly number of ingestions for the two groups was calculated for six time periods related to the FDA advisories. RESULTS: The mean monthly number of total paroxetine ingestions between January 2002 and June 2003 was 77.6. This declined by 23.3% to 59.6 in July 2003-March 2004 after an advisory about the risk of suicidality in youths using paroxetine. Comparable mean monthly numbers for patients aged /=20 years were 44.0 and 38.6, respectively (decline of 12.4%). Mean monthly numbers for total other SSRI ingestions were 206.4 and 243.1, respectively (increase of 17.8%). CONCLUSIONS: The FDA advisory in June 2003 appeared to initiate a decline in paroxetine ingestions, particularly among patients aged

A systematic review and meta-analysis of the pharmacological treatment of cancer-related fatigue.

J Natl Cancer Inst. 2008 Aug 20; 100(16): 1155-66
Minton O, Richardson A, Sharpe M, Hotopf M, Stone P
Background Cancer-related fatigue is an important clinical problem. It is common, distressing, and often difficult to treat. There is a role for drug treatment of cancer-related fatigue, but no consensus has been reached on which drugs are useful. This systematic review and meta-analysis aims to review the available evidence and make recommendations for practice and research. Methods We searched the Cochrane register of controlled trials (through the second quarter 2007), Medline (January 1, 1966, through August 1, 2007), and EMBASE (January 1, 1980, through August 1, 2007) by use of a predetermined list of search terms. Cochrane Collaboration meta-analysis review methodology was used for this study. The change in fatigue score on the instrument used in each study and other outcomes of interest (adverse events and withdrawal rates) were compared between treatment and control arms by use of the standardized mean difference (SMD) with 95% confidence intervals (CIs). All statistical tests were two-sided. Results We identified 27 eligible trials of drug treatments for cancer-related fatigue (with a total of 6746 participants). The overall effect size for all drug classes was small. A meta-analysis of two studies (n = 264 patients) indicated that methylphenidate (a psychostimulant) was superior to placebo (standardized mean difference [SMD] in change in fatigue score = -0.30, 95% confidence interval [CI] = -0.54 to -0.05; P = .02) for treating cancer-related fatigue. A meta-analysis of 10 studies (n = 2226 patients) evaluating erythropoietin in anemic cancer patients who were undergoing chemotherapy indicated that erythropoietin was superior to placebo (SMD = -0.30, 95% CI = -0.46 to -0.29; P = .008). Among anemic patients (four studies with n = 964 patients), improvement in fatigue was associated with darbepoetin treatment compared with placebo treatment (SMD = -0.13, 95% CI = -0.27 to 0.00; P = .05). Progestational steroids and paroxetine were no better than placebo in the treatment of cancer-related fatigue. Conclusions There is some evidence that treatment of cancer-related fatigue with methylphenidate appears to be effective. More robust evidence indicates that treatment with hematopoietic agents appears to relieve cancer-related fatigue caused by chemotherapy-induced anemia. Further confirmatory trials are required for both observations.

Economic impact of non-persistence to antidepressant therapy in the Quebec community-dwelling elderly population.

J Affect Disord. 2008 Aug 9;
Tournier M, Moride Y, Crott R, Galbaud du Fort G, Ducruet T
BACKGROUND: In a real-life setting, differences across newer antidepressants in patterns of use remain poorly explored, particularly in the older patients despite the high prevalence of late-life depression. METHODS: An observational retrospective cohort study was conducted in the community-dwelling elderly population of Quebec using health databases to compare the newer antidepressants with respect to non-persistence, associated health care costs and cost/persistence ratio. A random sample of 12,825 outpatients who initiated an antidepressant treatment in 2000 were followed for 12 months. Non-persistence was defined as treatment duration of less than 180 days. Economic variables included direct costs of prescribed medications, medical services and hospitalizations assessed through RAMQ claims databases and Med-Echo hospitalization database. Cost/persistence ratio and incremental cost/persistence ratio were obtained for each antidepressant product; persistence being considered as an indicator of effectiveness. RESULTS: 55.6% of antidepressant treatments were non-persistent. Products associated with low antidepressant costs were often associated with high costs of other medications and health care services, and vice versa. Paroxetine was associated with the lowest non-persistence (50.5%; 95%CI 48.5-52.5) and one of the most favourable cost/persistence ratios (CDN$4869 per persistent treatment). Fluoxetine was associated with the most favourable incremental cost/persistence ratio. LIMITATIONS: Some services and hospitalizations are not included in the administrative databases. No data on indication for treatment were available. These were likely to be non-differential across newer antidepressants. CONCLUSION: As found in other populations, non-persistence with antidepressant treatment is very frequent in the Quebec elderly population. Products associated with poor persistence result in increased health care costs. Hence, intervention programs aimed at improving persistence would optimize the use of health care resources and result in economic advantages.

[Evaluation of the effectiveness of crenotherapy in treating generalized anxiety disorder]

Sante Publique. 2008 Mar-Apr; 20(2): 105-12
Salamon R, Christine G, Olié JP, Dubois O
In preliminary studies, crenotherapy has emerged as a possible effective treatment for general anxiety disorder. We have compared crenotherapy to Paroxetine in a randomized multicentric control trial for a period of 8 weeks. 237 patients who met the diagnosis criteria of generalized anxiety disorder (DSM-IV) were recruited, 117 patients were randomly assigned to Crenotherapy and 120 to Paroxetine. Evaluation of effectiveness was assessed using the scoring system according to the Hamilton Rating Scale for Anxiety (HAMA). 207 patients were followed throughout the trial and completed the study. The HAMA scores showed an improvement across the two groups with a significant advantage of Crenotherapy compared with Paroxetine (p < 0.0001). The establishment and implementation of this trial have raised several methodological problems (namely because the use of a placebo was not possible) that are discussed by the authors.

 

This page was last reviewed by Dr Greg Mulhauser, Friday, 4 July 2008.

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