No abstract available.
Paroxetine*

Paroxetine is a well-known selective serotonin reuptake inhibitor, and has been reported to be advantageous for chronic pain control. Paroxetine is increasingly used for various types of chronic pain because of its safety; however, hyponatremia, or syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with paroxetine, has been reported. This complication is relatively rare, but some patients have presented with severe neurological symptoms. Here, we report the first case of SIADH associated with paroxetine in Korea.
Chronic Pain ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Korea ; Paroxetine ; Serotonin

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.
Citalopram* ; Depression ; Depressive Disorder, Major* ; Humans ; Paroxetine* ; Venlafaxine Hydrochloride*

OBJECTIVE: This study consists of a single open clinical trial to evaluate the treatment effects of paroxetine on symptoms of hwa-byung, a Korean culture-related anger syndrome. METHODS: Eighty-nine patients with depressive disorders, anxiety disorders, somatoform disorders, or self-labeled hwa-byung were treated with paroxetine (Paxil CR) 12.5-37.5 mg/day for 8 weeks. Treatment effects were evaluated using the Hamilton Depression Scale (HAMD), the State and Trait Anger Inventory (STAXI), and the Hwa-byung Scale. RESULTS: Scores on all items ; total score on the Hwa-byung Scale ; scores on state anger, trait anger, and anger-in ; total score on the STAXI ; and total score on the HAM-D decreased significantly after eight weeks of paroxetine treatment compared to baseline. CONCLUSION: Paroxetine was shown to be effective for treating symptoms of hwa-byung, a chronic anger syndrome.
Anger ; Anxiety Disorders ; Depression ; Depressive Disorder ; Humans ; Paroxetine ; Somatoform Disorders

After immersion in a foreign language, speakers often have difficulty retrieving native-language words and may experience a decrease in its proficiency, this phenomenon, in the non-pathological form, is known as first language attrition. Self-perception of this low native-language proficiency and apprehension occurring when speaking is expected and, may sometimes lead these people to a state of social anxiety and, in extreme forms, can involve the withholding of speech as a primitive tool for self-protection, linking them to selective mutism. We report an unusual case of selective mutism arising from first language attrition in an Italian girl after attending a two-year "German language school", who successfully responded to a paroxetine-cognitive behavioral treatment (CBT) combination treatment.
Anxiety ; Cognitive Therapy ; Female ; Humans ; Immersion ; Mutism* ; Paroxetine ; Self Concept

This is a systematic review and meta-analysis on the efficacy of ondemand tramadol for the treatment of lifelong premature ejaculation.

METHODS: A systematic review and meta-analysis with metaregression of trials evaluating the use of tramadol to treat premature ejaculation using intravaginal ejaculation latency time as a measure.Relevant studies were identified using PubMed, Ebscohost,MEDLINE, EMBASE and the Cochrane Collaboration Library.

RESULTS: This analysis included 8 publications. Study of the intravaginal ejaculation latency time (IELT) among 599 patients showed that tramadol was effective in subjects with premature ejaculation as seen by the significant difference in mean IELT of tramadol treated patients versus those receiving placebo (mean difference 2.43 minutes; 95% CI 0.93-3.93; P=0.002). The effect on IELT between tramadol and paroxetine was not statistically significant (mean difference -0.58; 95% CI -5.81 to 4.65; P=0.83).Meta-regression analysis showed that the lower the dose of tramadol,the higher its benefit in the prolongation of IELT, however, there was no significant difference (95% CI regression coefficient -0.0956 to 0.0322). There was a significant difference in adverse effects profile of tramadol versus placebo (risk ratio 2.48; 95% CI 1.55-3.98; overall effect Z= 3.79; P<0.0002) and overall therapeutic effectiveness between tramadol compared to placebo (risk ratio 0.55; 95% CI 0.46-0.67; P<0.00001).

CONCLUSION: On-demand tramadol is an effective treatment for lifelong premature ejaculation. It significantly prolongs the intravaginal ejaculation latency time. The overall adverse events and overall therapeutic effectiveness are significantly greater during treatment with tramadol.

OBJECTIVE: To observe the effect of Huayu Tongluo (resolving stasis and promoting collateral circulation) moxibustion combined with intradermal needling on depressive symptoms, quality of life and cognitive impairment in patients with mild to moderate depression after cerebral infarction on the basis of western medicine treatment. METHODS: Fifty patients with mild to moderate depression after cerebral infarction were randomly divided into an acupuncture combined with western medication group (group A, 25 cases) and a western medication group (group B, 25 cases). In the group B, paroxetine hydrochloride tablets were taken orally, 20 mg after breakfast, once a day, and the dose could be adjusted to the maximum 40 mg/d according to the patients' condition, for 4 weeks totally. On the basis of the treatment in the group B, the group A was treated with Huayu Tongluo moxibustion, namely aconite cake-separated moxibustion at Baihui (GV 20) and suspended moxibustion at Dazhui (GV 14) and Shenting (GV 24), combined with intradermal needling at Shenmen (HT 7), Jianshi (PC 5), Zusanli (ST 36), etc. Huayu Tongluo moxibustion was performed 6 times a week, and intradermal needling was performed 3 times a week，for 4 weeks totally. In the two groups, the scores of Hamilton depression scale (HAMD), stroke specific quality of life scale (SS-QOL) and mini mental state examination (MMSE) were observed before and after treatment, and the clinical efficacy and safety were compared. RESULTS: After treatment, the HAMD score in the each group was decreased compared with that before treatment (P<0.05), and that in the group A was lower than the group B (P<0.05); after treatment, the SS-QOL score in the group A and MMSE score in the two groups were increased compared with those before treatment (P<0.05), and the SS-QOL score in the group A was higher than the group B (P<0.05). The total effective rate was 88.0% (22/25) in the group A, which was higher than 60.0% (15/25) in the group B (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (4.0% [1/25] vs 16.0%[4/25], P>0.05). CONCLUSION On the basis of the treatment of western medication paroxetine hydrochloride tablets, Huayu Tongluo moxibustion combined with intradermal needling therapy can effectively improve the depressive symptoms, quality of life and cognitive impairment of patients with mild to moderate depression after cerebral infarction.
Humans ; Moxibustion ; Quality of Life ; Paroxetine ; Depression/therapy* ; Cerebral Infarction/therapy*

Selective serotonin reuptake inhibitors are commonly prescribed drugs for the treatment of depression in the patients with diabetes. Here, we report a case of paroxetineinduced severe recurrent hypoglycemia that developed in a 35-year-old woman with poorly controlled type 2 diabetes complicated by diabetic nephropathy and neuropathy. She discontinued her daily insulin therapy 2 months after the introduction of paroxetine, but hypoglycemic events were sustained. After discontinuation of paroxetine, no more hypoglycemic events occurred.
Adult ; Depression ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; Female ; Humans ; Hypoglycemia* ; Insulin ; Paroxetine ; Serotonin Uptake Inhibitors

OBJECTIVES: Paroxetine is known to have fewer cognitive side effects than older antidepressants such as amitriptyline. To confirm this objectively, we compared the effects of paroxetine on the psychomotor performance with those of amitriptyline in 10 healthy volunteers. METHOD: Paroxetine and amitriptyline were administered orally in a double-blind, two-way, single dose, crossover design. Assessments of psychomotor performances were carried out before and 2 and 6 hours after administration of single dose of paroxetine (40mg) or amitriptyline (50mg). Each treatment day was separated by 1 week of washout period. The psychomotor performances were measured using Vienna Determination Unit, Vienna Reaction Time, Vienna Signal Detection, Grooved Pegboard Test and Finger Tapping Test. The data were analyzed using two-way, repeated measures ANOVA on a crossover model. RESULTS: The results showed that paroxetine 40mg produced no significant performance decrements on the every test of psychomotor performances, whereas amitriptyline 50mg produced markedly impaired performance on most of the psychomotor tests. CONCLUSION: This study confirmed pervious findings that paroxetine is generally devoid of adverse side effects on psychomotor performance.
Amitriptyline* ; Antidepressive Agents ; Cross-Over Studies ; Fingers ; Healthy Volunteers* ; Paroxetine* ; Psychomotor Performance ; Reaction Time

BACKGROUND AND PURPOSE: Anxiety is the most important precipitating factor of migraine attacks, and more than half of migraineurs have coexisting anxiety disorders. Paroxetine, an antidepressant, is one of the selective serotonin reuptake inhibitors (SSRIs) that has an anxiolytic effect, and is also known to be effective for migraine prophylaxis. The aim of this study was to determine the role of the anxiolytic effect of paroxetine on the prevention of migraine. METHODS: This study investigated migraineurs with a general anxiety disorder who visited the neurological clinic. The following efficacy variables were assessed at baseline and after taking paroxetine (20 for 12 weeks: headache frequency, Hamilton Anxiety Rating Scale (HAM-A), Headache Management Self-Efficacy Scale (HMSE), and Headache Disability Inventory (HDI). The correlation between the headache responsiveness to paroxetine and improvement in anxiety levels was analyzed. RESULTS: Twenty-four patients (aged 54.96+/-12.09 years, mean+/-SD) were included in this study. Paroxetine reduced headache frequency by 49.1% within 12 weeks (p<0.05 vs baseline). HAM-A and HMSE scores also showed an improvement, whereas there was no significant change in HDI score. The baseline HAM-A scores did not differ between paroxetine responders and nonresponders. In addition, the improvement in HAM-A score was not correlated with the reduction in headache frequency. CONCLUSIONS: Paroxetine decreased the headache frequency and reduced anxiety levels. However, the anxiolytic effect of paroxetine was not correlated with the migraine prevention effect. These observation indicate that the anxiolytic effect of paroxetine does not contribute strongly to its prophylactic effect on migraine frequency in migraineurs with anxiety disorder.
Anti-Anxiety Agents* ; Anxiety ; Anxiety Disorders ; Headache ; Humans ; Migraine Disorders* ; Paroxetine* ; Precipitating Factors ; Serotonin Uptake Inhibitors