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KMID : 1009020170150040391
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Clinical Psychopharmacology and Neuroscience
2017 Volume.15 No. 4 p.391 ~ p.401
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Paroxetine versus Venlafaxine and Escitalopram in Korean Patients with Major Depressive Disorder: A Randomized, Rater-blinded, Six-week Study
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Woo Young-Sup
McIntyre Roger S.
Kim Jung-Bum
Lee Min-Soo
Kim Jae-Min
Yim Hyeon-Woo
Jun Tae-Youn
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Abstract
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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-Asberg 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.
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KEYWORD
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Paroxetine, Venlafaxine, Escitalopram, Major depressive disorder, Korean
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