Paroxetine and imipramine: A 12-week, double-blind, multicentre study in hospitalized depressed patients

A multicentre, double-blind comparison of paroxetine and imipramine was carried out in five centres over 12 weeks. Patients received paroxetine (30 mg) or imipramine (150 mg) daily. Efficacy was assessed using HAMD, MADRS, and a global assessment. The Beck self-rating scale was optional. Tolerability was assessed using the UKU side-effects checklist and a global evaluation by both investigators and patients. Fifty-seven patients with DSM-III depression (25 on paroxetine and 32 on imipramine) entered the study. Both treatments showed a fast onset of action, and from week 3 there was a trend with respect to further improvement in favour of paroxetine according to the HAMD scale. Similar results were obtained with the MADRS but the trend in favour of paroxetine occurred at week 2. Eighty-six per cent of patients on paroxetine were judged complete responders compared with 72% on imipramine. Side-effects symptoms increased in severity in patients on imipramine, including the anticholinergic symptoms of reduced salivation, micturition disturbance, and orthostatic hypotension, compared with four symptoms in paroxetine patients. Significantly more patients on paroxetine, according to a global evaluation, had no side-effects compared with those on imipramine. It was concluded that paroxetine was as effective as imipramine but showed superior tolerability.