SynthesisCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2008
Effectiveness of paroxetine in the treatment of acute major depression in adults: a systematic re-examination of published and unpublished data from randomized trials.
Synthesis in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 10 syntheses or guidelines pooled it, 125 citations in OpenAlex.
- Pooled it
- Paroxetine versus other anti-depressive agents for depression.The Cochrane database of systematic reviews · 2014Pooled it
- Amitriptyline versus placebo for major depressive disorder.The Cochrane database of systematic reviews · 2012Pooled it
- Quetiapine monotherapy in acute phase for major depressive disorder: a meta-analysis of randomized, placebo-controlled trials.BMC psychiatry · 2012Pooled it
- [Considerations about the efficacy of psychopharmacological drugs].Der Nervenarzt · 2011Pooled it
- Examination of the utility of psychotherapy for patients with treatment resistant depression: a systematic review.Journal of general internal medicine · 2011Pooled it
- Depression in adults: drug and physical treatments.BMJ clinical evidence · 2011Pooled it
- Fluvoxamine versus other anti-depressive agents for depression.The Cochrane database of systematic reviews · 2010Pooled it
- Selective serotonin reuptake inhibitors and risk of suicide: a systematic review of observational studies.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2009Pooled it
- Selective serotonin reuptake inhibitors for unipolar depression: a systematic review of classic long-term randomized controlled trials.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2008Pooled it
- Lack of association between pretreatment glutamate/GABA and major depressive disorder treatment response.Translational psychiatry · 2025Trial
- The nature of depression and the biomedical model: ten questions in search of an answer.Translational psychiatry · 2026Review
- The problem of suicidality, personality disorder, and treatment: an alternative psycho-social perspective.Research in psychotherapy (Milano) · 2024Article
- Comparative Efficacy of Animal Depression Models and Antidepressant Treatment: A Systematic Review and Meta-Analysis.Pharmaceutics · 2024Review
- Article
- Article
- Does Psychedelic Therapy Have a Transdiagnostic Action and Prophylactic Potential?Frontiers in psychiatry · 2021Article
- Article
- A neural circuit for comorbid depressive symptoms in chronic pain.Nature neuroscience · 2019Article
- Subjective Versus Objective Outcomes of Antipsychotics for the Treatment of Neuropsychiatric Symptoms Associated with Dementia.CNS drugs · 2019Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundConcern has been raised about the efficacy of antidepressant therapy for major depression in adults. We undertook a systematic review of published and unpublished clinical trial data to determine the effectiveness and acceptability of paroxetine.
methodsWe searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register, the Cochrane Central Register of Controlled Trials, the GlaxoSmithKline Clinical Trial Register, MEDLINE and EMBASE up to December 2006. Published and unpublished randomized trials comparing paroxetine with placebo in adults with major depression were eligible for inclusion. We selected the proportion of patients who left a study early for any reason as the primary outcome measure because it represents a hard measure of treatment effectiveness and acceptability.
resultsWe included in our review 29 published and 11 unpublished clinical trials, with a total of 3704 patients who received paroxetine and 2687 who received with placebo. There was no difference between paroxetine and placebo in terms of the proportion of patients who left the study early for any reason (random effect relative risk [RR] 0.99, 99% confidence interval [CI] 0.88-1.11). Paroxetine was more effective than placebo, with fewer patients who did not experience improvement in symptoms of at least 50% (random effect RR 0.83, 99% CI 0.77-0.90). Significantly more patients in the paroxetine group than in the placebo group left their respective studies because of side effects (random effect RR 1.77, 95% CI 1.44-2.18) or experienced suicidal tendencies (odds ratio 2.55, 95% CI 1.17-5.54).
interpretationAmong adults with moderate to severe major depression in the clinical trials we reviewed, paroxetine was not superior to placebo in terms of overall treatment effectiveness and acceptability. These results were not biased by selective inclusion of published studies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.