Efficacy and tolerability of paroxetine in adults with social anxiety disorder

Li, Xinyuan; Hou, Yan-Bo; Su, Yingying; Liu, Hongping; Zhang, Beilin; Fang, Shaokuan

doi:10.1097/md.0000000000019573

Cited by 6 publications

(7 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The nonspecific aspects of treatment underlying the placebo response include the expectation of benefit, support from a clinician showing concern and attention, and symptom resolution due to the natural history of the disorder. For mood and anxiety disorders, recent meta-analyses have found placebo response rates of 35% to 40% for major depressive disorder (Papakostas et al, 2016), 30% to 40% for bipolar depression (Bartoli et al, 2018; Papakostas et al, 2016), 30% for bipolar mania (Bartoli et al, 2018; Welten et al 2015), 45% to 50% for panic disorder (Zhang et al, 2020), 40–50% for generalized anxiety disorder (Li et al, 2017), and 35% to 40% for social anxiety disorder (Li et al, 2020). Appreciable placebo response rates have even been found for patients who are considered treatment resistant.…”

Section: Why Improved Outcome Is Unlikelymentioning

confidence: 99%

Should the demonstration of improved patient outcome be necessary to overhaul diagnostic approaches?: Comment on Bach and Tracy (2022).

Zimmerman¹

2022

Personality Disorders: Theory, Research, and Treatment

View full text Add to dashboard Cite

I will argue in this commentary that it is premature to change the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition approach toward diagnosing personality disorders to the alternative model for personality disorders (AMPD) because such a change in determining personality pathology will be disruptive, and such a disruption is warranted only when it can be demonstrated that patient outcomes are better. I briefly review studies comparing unstructured clinical evaluations with semistructured interviews for symptom disorders, and these studies have found that there is a high rate of missed diagnoses and misdiagnosis by usual clinical assessment. Although on common sense grounds it seems reasonable to assume that greater diagnostic precision will improve outcome, semistructured interviews are not recommended as the standard of care because no studies of adults have yet demonstrated that patient outcomes are better when semistructured interviews are used instead of unstructured clinical interviews. This logic equally applies to overhauling a diagnostic system. In fact, upon considering an approach toward subtyping patients based on outcome in treatment, it is unlikely that a study randomly assigning patients to competing diagnostic or assessment approaches would demonstrate superiority of one method over the other. Finally, I raise concerns about reliance on self-report scales to assess personality and note an absence of studies comparing self-report and interviewer assessments of the AMPD that computed or discussed the positive predictive value of self-report measures of the AMPD system.

show abstract

Section: Why Improved Outcome Is Unlikelymentioning

confidence: 99%

Should the demonstration of improved patient outcome be necessary to overhaul diagnostic approaches?: Comment on Bach and Tracy (2022).

Zimmerman¹

2022

Personality Disorders: Theory, Research, and Treatment

View full text Add to dashboard Cite

show abstract

“…For this reason, no antidepressants, including paroxetine, are contraindicated in children [ 34 , 38 , 39 ]. Antidepressants are used to treat depression and prevent disease-induced suicide, the possibility that drug-induced suicide can appear as side effect is a serious issue that needs to be thoroughly investigated [ 27 , 38 , 39 , 40 , 41 ]. Existing studies on the link between suicide and antidepressants vary with different results and continue to cause a lot of controversy [ 32 , 33 , 34 , 35 , 36 ].…”

Section: Paroxetine—general Information and Historymentioning

confidence: 99%

“…Existing studies on the link between suicide and antidepressants vary with different results and continue to cause a lot of controversy [ 32 , 33 , 34 , 35 , 36 ]. In addition, it is estimated that the risk of negative effects of untreated or undertreated depression is usually higher than the risk of drug-induced suicide [ 27 , 41 ].…”

Section: Paroxetine—general Information and Historymentioning

confidence: 99%

Paroxetine—Overview of the Molecular Mechanisms of Action

Kowalska

Nowaczyk

Fijałkowski

et al. 2021

IJMS

View full text Add to dashboard Cite

In the 21st century and especially during a pandemic, the diagnosis and treatment of depression is an essential part of the daily practice of many family doctors. It mainly affects patients in the age category 15–44 years, regardless of gender. Anxiety disorders are often diagnosed in children and adolescents. Social phobias can account for up to 13% of these diagnoses. Social anxiety manifests itself in fear of negative social assessment and humiliation, which disrupts the quality of social functioning. Treatment of the above-mentioned disorders is based on psychotherapy and pharmacotherapy. Serious side effects or mortality from antidepressant drug overdose are currently rare. Recent studies indicate that paroxetine (ATC code: N06AB), belonging to the selective serotonin reuptake inhibitors, has promising therapeutic effects and is used off-label in children and adolescents. The purpose of this review is to describe the interaction of paroxetine with several molecular targets in various points of view including the basic chemical and pharmaceutical properties. The central point of the review is focused on the pharmacodynamic analysis based on the molecular mechanism of binding paroxetine to various therapeutic targets.

show abstract

“…Previous meta-analyses assessed the tolerability of SSRIs and SNRIs in the treatment of non-depressive disorders, but three key questions remain unanswered. First, previous studies restricted their inclusion criteria to specific medications (Li et al, 2018, 2020; Li, Zhu, Su, & Fang, 2017; Liu et al, 2018; Zhang et al, 2020), diagnoses (Li et al, 2020, 2017, 2018; Liu et al, 2018; Zhang et al, 2020), adverse events (Telang, Walton, Olten, & Bloch, 2018; Wang et al, 2022), or populations (Schwartz, Barican, Yung, Zheng, & Waddell, 2019). Thus, no large-scale quantitative review or network meta-analysis evaluated the comparative tolerability and rates of most adverse events associated with all SSRIs and SNRIS for the treatment of anxiety, obsessive-compulsive, and stress-related disorders.…”

Section: Introductionmentioning

confidence: 99%

Incidence of adverse events and comparative tolerability of selective serotonin reuptake inhibitors, and serotonin and norepinephrine reuptake inhibitors for the treatment of anxiety, obsessive-compulsive, and stress disorders: a systematic review and network meta-analysis

et al. 2023

View full text Add to dashboard Cite

Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) show similar efficacy as treatments for anxiety, obsessive-compulsive, and stress-related disorders. Hence, comparisons of adverse event rates across medications are an essential component of clinical decision-making. We aimed to compare patterns of adverse events associated with SSRIs and SNRIs in the treatment of children and adults diagnosed with these disorders through a network meta-analysis. We searched MEDLINE, PsycINFO, Embase, Cochrane, websites of regulatory agencies, and international registers from inception to 09 September 2022, for randomized controlled trials assessing the efficacy of SSRIs or SNRIs. We analyzed the proportion of participants experiencing at least one adverse event and incidence rates of 17 specific adverse events. We estimated incidence rates and odds ratios through network meta-analysis with random effects and three-level models. We analyzed 799 outcome measures from 80 studies (n = 21 338). Participants in medication groups presented higher rates of adverse events (80.22%, 95% CI 76.13–83.76) when compared to placebo groups (71.21%, 67.00–75.09). Nausea was the most common adverse event (25.71%, CI 23.96–27.54), while weight change was the least common (3.56%, 1.68–7.37). We found higher rates of adverse events of medications over placebo for most medications, except sertraline and fluoxetine. We found significant differences between medications for overall tolerability and for autonomic, gastrointestinal, and sleep-related symptoms. Adverse events are a common reason that patients discontinue SSRIs and SNRIs. Results presented here guide clinical decision-making when clinicians weigh one medication over another. This might improve treatment acceptability and compliance.

show abstract

Efficacy and tolerability of paroxetine in adults with social anxiety disorder

Cited by 6 publications

References 29 publications

Should the demonstration of improved patient outcome be necessary to overhaul diagnostic approaches?: Comment on Bach and Tracy (2022).

Should the demonstration of improved patient outcome be necessary to overhaul diagnostic approaches?: Comment on Bach and Tracy (2022).

Paroxetine—Overview of the Molecular Mechanisms of Action

Incidence of adverse events and comparative tolerability of selective serotonin reuptake inhibitors, and serotonin and norepinephrine reuptake inhibitors for the treatment of anxiety, obsessive-compulsive, and stress disorders: a systematic review and network meta-analysis

Contact Info

Product

Resources

About