Meta-regression analysis of paroxetine clinical trial data: does reporting scale matter?

Abstract:

OBJECTIVES:It is unknown to which degree the effect of antidepressant drugs are related to baseline degree of depression, dose level, patient's age, or type of questionnaire used. We explored this for paroxetine. METHODS:We used placebo-controlled published and unpublished randomized, double-blind, clinical trials of paroxetine that included moderate to severely depressed patients in an outpatient setting. We specified random-effect models for the Hamilton 17-item and Hamilton 21-item studies separately and jointly. RESULTS:Among 35 studies retrieved, we considered 26 appropriate for a pooled analysis. Paroxetine (placebo) was given to 2958 (2123) patients. We found that the effects of paroxetine, the differences between score reduction in drug versus placebo group, are smaller in Hamilton 17 (3.8%) than in Hamilton 21 studies (7.0%). The mean difference is 3.2% (95% confidence interval, 0.94%-5.42%), statistically significant by meta-regression analysis. Treatment effects did not change with mean age of patients, early or late studies, baseline score value, or maximal daily dose. CONCLUSIONS:We forward 2 hypotheses for explanation. The Hamilton 21 studies had better selection of patients, thereby smaller effect of regression to the mean than the Hamilton 17 studies, meaning the Hamilton 21 studies reveal true somewhat higher treatment effects. Alternatively, the study groups contained some patients with psychotic symptoms tested for with the Hamilton 21-item questionnaire and thereby becoming decisive for the outcome. If so, paroxetine would have an antipsychotic effect. This is in accordance with some experimental and clinical observations.

journal_name

J Clin Psychopharmacol

authors

Klemp M,Tvete IF,Gåsemyr J,Natvig B,Aursnes I

doi

10.1097/JCP.0b013e318210bac1

subject

Has Abstract

pub_date

2011-04-01 00:00:00

pages

201-6

issue

2

eissn

0271-0749

issn

1533-712X

journal_volume

31

pub_type

杂志文章,meta分析
  • Rating the raters: assessing the quality of Hamilton rating scale for depression clinical interviews in two industry-sponsored clinical drug trials.

    abstract:OBJECTIVE:The quality of clinical interviews conducted in industry-sponsored clinical drug trials is an important but frequently overlooked variable that may influence the outcome of a study. We evaluated the quality of Hamilton Rating Scale for Depression (HAM-D) clinical interviews performed at baseline in 2 similar ...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章

    doi:10.1097/01.jcp.0000194621.61868.7c

    authors: Engelhardt N,Feiger AD,Cogger KO,Sikich D,DeBrota DJ,Lipsitz JD,Kobak KA,Evans KR,Potter WZ

    更新日期:2006-02-01 00:00:00

  • The Utility of Low-Dose Aripiprazole for the Treatment of Bipolar II and Bipolar NOS Depression.

    abstract:BACKGROUND:Despite initial reports of efficacy in bipolar depression, multicenter trials did not show aripiprazole to be better than placebo, possibly because the doses used were too high, leading to lower efficacy and high dropout rates. This study evaluated the effects of low-dose aripiprazole. Extensive clinical exp...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章

    doi:10.1097/JCP.0000000000000636

    authors: Kelly T,Lieberman DZ

    更新日期:2017-02-01 00:00:00

  • A double-blind, randomized, fluoxetine-controlled, multicenter study of paroxetine in the treatment of depression.

    abstract::Paroxetine is a novel phenylpiperidine antidepressant agent that acts as a potent and selective inhibitor of serotonin reuptake. We report results of a 6-week, randomized, double-blind, multicenter study comparing paroxetine and fluoxetine in the treatment of major depression. One hundred seventy-eight inpatients, who...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/00004714-199312002-00003

    authors: Tignol J

    更新日期:1993-12-01 00:00:00

  • Intersubject variation in the pharmacokinetics of haloperidol and reduced haloperidol.

    abstract::Single oral doses (5 mg) of haloperidol were administered to 36 healthy men (26 black, 10 white) of whom 28 (22 black, 6 white) completed the study. Plasma samples harvested over 96 hours were analyzed for haloperidol and reduced haloperidol by means of a new high performance liquid chromatographic method. Reduced hal...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章

    doi:10.1097/00004714-198904000-00005

    authors: Midha KK,Chakraborty BS,Ganes DA,Hawes EM,Hubbard JW,Keegan DL,Korchinski ED,McKay G

    更新日期:1989-04-01 00:00:00

  • A double-blind, placebo-controlled trial of lamotrigine for pathological skin picking: treatment efficacy and neurocognitive predictors of response.

    abstract::Although a relatively common behavior, treatment data for pathological skin picking (PSP) are limited. The current study sought to examine the efficacy and tolerability of lamotrigine in adults with PSP and to examine neurocognitive predictors of treatment response. Thirty-two subjects (29 female subjects [90.6%]; mea...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/JCP.0b013e3181e617a1

    authors: Grant JE,Odlaug BL,Chamberlain SR,Kim SW

    更新日期:2010-08-01 00:00:00

  • Specific side effects of long-term imipramine management of panic disorder.

    abstract::In a recent study, the authors suggested that tachycardia, dry mouth, and sweating continued to burden patients with panic disorder with agoraphobia who have shown marked and stable response to 6 months of imipramine treatment at the fixed, weight-adjusted dose of 2.25 mg/kg/day. Although sexual dysfunction and weight...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00004714-200204000-00008

    authors: Mavissakalian M,Perel J,Guo S

    更新日期:2002-04-01 00:00:00

  • Central nervous system stimulants as symptomatic treatments for AIDS-related neuropsychiatric impairment.

    abstract::Seven patients with AIDS-related cognitive and emotional deficits had neuropsychologic testing and then were treated with methylphenidate or dextroamphetamine in individualized doses. Three patients showed marked functional improvement and 5 of the 7 became more spontaneous, reactive, and animated. Additional neuropsy...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 临床试验,杂志文章

    doi:

    authors: Angrist B,d'Hollosy M,Sanfilipo M,Satriano J,Diamond G,Simberkoff M,Weinreb H

    更新日期:1992-08-01 00:00:00

  • Pharmacokinetics of valproate and carbamazepine.

    abstract::Over the past 10 years, knowledge gained about the pharmacokinetic profiles of valproate and carbamazepine has increased the clinical effectiveness of their use. Much of the information has been gained through their use as successful antiepileptic medications. As these agents begin to play an increasing role as mood-s...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章

    doi:10.1097/00004714-199202001-00010

    authors: Wilder BJ

    更新日期:1992-02-01 00:00:00

  • Early adverse events and attrition in selective serotonin reuptake inhibitor treatment: a suicide assessment methodology study report.

    abstract::Adverse events during selective serotonin reuptake inhibitor (SSRI) treatment are frequent and may lead to premature treatment discontinuation. If attrition is associated with early worsening of adverse effects or the frequency, intensity, or burden of adverse effects, interventions to maximize retention could be focu...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1097/JCP.0b013e3181dbfd04

    authors: Warden D,Trivedi MH,Wisniewski SR,Kurian B,Zisook S,Kornstein SG,Friedman ES,Miyahara S,Leuchter AF,Fava M,Rush AJ

    更新日期:2010-06-01 00:00:00

  • Fluoxetine: activating and sedating effects at multiple fixed doses.

    abstract::Serotonin uptake inhibitors are generally considered activating antidepressants. To assess rates and temporal patterns of activation and sedation as well as dose-effect relationships, adverse event data were evaluated from a fixed-dose study comparing placebo and fluoxetine 5, 20, and 40 mg/day in the treatment of maj...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:

    authors: Beasley CM Jr,Sayler ME,Weiss AM,Potvin JH

    更新日期:1992-10-01 00:00:00

  • Psychological strategies for discontinuing benzodiazepine treatment.

    abstract::Successful discontinuation of therapeutic drugs requires patients to negotiate two potentially difficult phases. First, they must complete the drug discontinuation procedure itself, which may entail coping with rebound and withdrawal symptoms as well as anxiety due to stopping a treatment on which they depend psycholo...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章,评审

    doi:10.1097/00004714-199912002-00004

    authors: Spiegel DA

    更新日期:1999-12-01 00:00:00

  • Medication adherence in outpatients with severe mental disorders: relation between self-reports and serum level.

    abstract::Medication nonadherence in severe mental disorders is an important clinical issue, but estimates vary between studies. There is a need for valid self-reports for both research and clinical practice. This study examined the level of adherence to prescribed medication in outpatients with severe mental disorders and eval...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章

    doi:10.1097/JCP.0b013e3181d2191e

    authors: Jónsdóttir H,Opjordsmoen S,Birkenaes AB,Engh JA,Ringen PA,Vaskinn A,Aamo TO,Friis S,Andreassen OA

    更新日期:2010-04-01 00:00:00

  • Aripiprazole and dehydroaripiprazole plasma concentrations and clinical responses in patients with schizophrenia.

    abstract::Aripiprazole is widely used to treat schizophrenia. Plasma levels of aripiprazole and its active metabolite dehydroaripiprazole and their clinical responses in patients were explored. Forty-five (male/female: 19/26) patients with schizophrenia were treated with aripiprazole after a washout period of at least 3 days. T...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 临床试验,杂志文章

    doi:10.1097/JCP.0b013e3182356255

    authors: Lin SK,Chen CK,Liu YL

    更新日期:2011-12-01 00:00:00

  • Effects of Intranasal Oxytocin Administration on Sexual Functions in Healthy Women: A Laboratory Paradigm.

    abstract:PURPOSE:The neuropeptide oxytocin (OXT) has a variety of physiological functions in maternal behavior and attachment including sexual behavior. Based on animal research and our previous human studies, we set out to investigate intranasal administration of OXT and hypothesized that OXT should be able to modulate sexual ...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/JCP.0000000000000863

    authors: Kruger THC,Deiter F,Zhang Y,Jung S,Schippert C,Kahl KG,Heinrichs M,Schedlowski M,Hartmann U

    更新日期:2018-06-01 00:00:00

  • Effectiveness of pindolol with selected antidepressant drugs in the treatment of major depression.

    abstract::On the basis of a previous report suggesting the effectiveness of the beta-adrenoceptor/5-HT1A antagonist pindolol to accelerate the antidepressant effect of a selective serotonin reuptake inhibitor (SSRI) and to produce a therapeutic effect in drug-resistant depressed patients, these open studies were undertaken to f...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 临床试验,杂志文章

    doi:10.1097/00004714-199506000-00011

    authors: Blier P,Bergeron R

    更新日期:1995-06-01 00:00:00

  • Improving treatment of depression in the elderly: two innovations in statistical design of clinical trials.

    abstract::Depression in the elderly patient may present special challenges for the design of clinical treatment trials due to a complex antidepressant treatment history, individual contraindications to certain medications, medical comorbidity, as well as concurrent medications for other medical conditions. The chronic, relapsin...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章,评审

    doi:10.1097/01.jcp.0000168502.16361.ad

    authors: Lavori PW

    更新日期:2005-08-01 00:00:00

  • Double-Blind, Randomized, Placebo-Controlled Trial of Metoclopramide for Hypersalivation Associated With Clozapine.

    abstract::Hypersalivation is a frequent, disturbing, and uncomfortable adverse effect of clozapine therapy that frequently leads to noncompliance. The aim of this study was to examine the efficacy of metoclopramide (dopamine D2 antagonist, antiemetic medication) as an option for management of hypersalivation associated with clo...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/JCP.0000000000000493

    authors: Kreinin A,Miodownik C,Mirkin V,Gaiduk Y,Yankovsky Y,Bersudsky Y,Lerner PP,Bergman J,Lerner V

    更新日期:2016-06-01 00:00:00

  • Alprazolam treatment of postcoronary bypass anxiety and depression.

    abstract::The effectiveness of alprazolam in treating symptoms of anxiety and depression in 60 patients undergoing coronary bypass surgery was assessed in a double-blind, placebo-controlled study. The results indicate that alprazolam treatment for anxiety following coronary bypass surgery, particularly symptoms occurring in the...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Freeman AM 3rd,Fleece L,Folks DG,Sokol RS,Hall KR,Pacifico AD,McGiffin DC,Kirklin JK,Zorn GL,Karp RB

    更新日期:1986-02-01 00:00:00

  • Monoamine oxidase inhibitor therapy for anorexia nervosa and bulimia: a preliminary trial of isocarboxazid.

    abstract::In an open prospective clinical study, 14 female outpatients with anorexia nervosa or bulimia completed a 6-week trial of isocarboxazid, with a mean dose of 34 mg. The eight bulimic and six restrictive anorexic subjects did not show any significant differences in medication response. Ratings of depression and anxiety ...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章

    doi:10.1097/00004714-198510000-00005

    authors: Kennedy SH,Piran N,Garfinkel PE

    更新日期:1985-10-01 00:00:00

  • Antidepressant properties of anticonvulsant drugs for bipolar disorder.

    abstract::A growing number of anticonvulsant drugs are receiving attention as possible mood stabilizers. This attention is based mainly on the assumption that the antimanic efficacy of anticonvulsants makes them suitable as mood stabilizers. However, their antidepressant properties have received less scrutiny. In this review, c...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章,评审

    doi:10.1097/00004714-200304000-00011

    authors: Ernst CL,Goldberg JF

    更新日期:2003-04-01 00:00:00

  • Ongoing lithium treatment prevents relapse after total sleep deprivation.

    abstract::Forty bipolar depressed inpatients underwent three consecutive cycles of total sleep deprivation (TSD). At the beginning of the study, 20 patients were free of psychotropic drugs and 20 had been receiving lithium medication for at least 6 months. Mood was rated on the Hamilton Rating Scale for Depression before and af...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 临床试验,杂志文章

    doi:10.1097/00004714-199906000-00007

    authors: Benedetti F,Colombo C,Barbini B,Campori E,Smeraldi E

    更新日期:1999-06-01 00:00:00

  • Prolactin and Estrogen Levels in Postmenopausal Women Receiving Aripiprazole Augmentation Treatment for Depression.

    abstract:BACKGROUND:Antipsychotic drugs are well established to alter serum prolactin levels, often resulting in adverse effects including amenorrhea, galactorrhea, osteoporosis, and loss of libido. There is growing preclinical evidence that prolactin-elevating drugs can instigate the progression of precancerous lesions to brea...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章

    doi:10.1097/JCP.0000000000001335

    authors: Rahman T,Patrick C,Ma C,Nicol GE,Reynolds CF 3rd,Mulsant BH,Hartz SM,Yingling M,Lenze EJ

    更新日期:2021-01-01 00:00:00

  • Predictors of treatment response in obsessive-compulsive disorder: multivariate analyses from a multicenter trial of clomipramine.

    abstract::There have been many attempts to find predictors of the therapeutic response to the clomipramine treatment of obsessive-compulsive disorder. The majority of studies have failed to identify such predictors. Possible reasons for this failure include the small sample size of most studies, samples homogeneous with respect...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:

    authors: Ackerman DL,Greenland S,Bystritsky A,Morgenstern H,Katz RJ

    更新日期:1994-08-01 00:00:00

  • Psychiatric reactions during tricyclic treatment of the elderly reconsidered.

    abstract::In a prospective study of all geriatric patients treated with tricyclic antidepressants over an 18-month period, a lower incidence of adverse psychiatric reactions than literature based on chart reviews has suggested was found. In only three of the 43 patients studied (7%) did a picture consistent with toxic delirium ...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章

    doi:

    authors: Meyers BS,Mei-Tal V

    更新日期:1983-02-01 00:00:00

  • Desipramine plasma levels and response in elderly melancholic patients.

    abstract::The relationship of response and plasma desipramine concentrations was examined in elderly depressed patients to determine whether they were more sensitive to the antidepressant effects of the drug and whether they would respond at lower plasma concentrations than younger patients. Twenty-five inpatients over the age ...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章

    doi:

    authors: Nelson JC,Jatlow PI,Mazure C

    更新日期:1985-08-01 00:00:00

  • Trends in the adoption of medications for alcohol dependence.

    abstract::Increasing attention is being paid to the development and dissemination of effective pharmacotherapies for the treatment of alcohol and other drug dependence. However, numerous structural and philosophical barriers impede the widespread adoption of these treatment approaches in everyday clinical practice. Research is ...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/01.jcp.0000246209.18777.14

    authors: Ducharme LJ,Knudsen HK,Roman PM

    更新日期:2006-12-01 00:00:00

  • Insulin Resistance-Related Proteins Are Overexpressed in Patients and Rats Treated With Olanzapine and Are Reverted by Pueraria in the Rat Model.

    abstract:BACKGROUND:Olanzapine, a commonly used second-generation antipsychotic, causes severe metabolic adverse effects, such as elevated blood glucose and insulin resistance (IR). Previous studies have proposed that overexpression of CD36, GGPPS, PTP-1B, GRK2, and adipose triglyceride lipase may contribute to the development ...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章

    doi:10.1097/JCP.0000000000001028

    authors: Yang N,Li S,Liu S,Lv Y,Yu L,Deng Y,Li H,Fang M,Huo Y,Li W,Peng S

    更新日期:2019-05-01 00:00:00

  • Mania after withdrawal of isocarboxazid.

    abstract::Two cases of mania following the discontinuation of treatment with isocarboxazid are described. Although this phenomenon has been reported by several investigators to occur after cessation of tricyclic antidepressant therapy, there exists only one isolated report of hypomania after discontinuation of monoamine oxidase...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章

    doi:

    authors: Rothschild AJ

    更新日期:1985-12-01 00:00:00

  • Pain Affects Clinical Patterns and Treatment Outcomes for Patients With Major Depressive Disorder Taking Fluoxetine.

    abstract::The aim of the study was to determine whether baseline pain was associated with discernible clinical features and treatment outcomes for patients with major depressive disorder (MDD) receiving 6-week fluoxetine treatment. A total of 131 inpatients with acutely ill MDD were enrolled to receive 20 mg of fluoxetine daily...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章

    doi:10.1097/JCP.0000000000000410

    authors: Lin HS,Wang FC,Lin CH

    更新日期:2015-12-01 00:00:00

  • Influence of olanzapine on QT variability and complexity measures of heart rate in patients with schizophrenia.

    abstract::Previous studies have shown that untreated patients with acute schizophrenia present with reduced heart rate variability and complexity as well as increased QT variability. This autonomic dysregulation might contribute to increased cardiac morbidity and mortality in these patients. However, the additional effects of n...

    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章

    doi:10.1097/JCP.0b013e31818a6d25

    authors: Bär KJ,Koschke M,Berger S,Schulz S,Tancer M,Voss A,Yeragani VK

    更新日期:2008-12-01 00:00:00