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


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 METHODS:We used placebo-controlled published and unpublished randomized, double-blind, clinical trials of paroxetine that included moderate to severely depressed patients in an outpatient setting.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.


J Clin Psychopharmacol


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




Has Abstract


2011-04-01 00:00:00












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    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...

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    pub_type: 杂志文章


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

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    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...

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    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...

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    pub_type: 临床试验,杂志文章,随机对照试验


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    更新日期:2002-04-01 00:00:00

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    更新日期:1992-08-01 00:00:00

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    pub_type: 杂志文章


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    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

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

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    pub_type: 杂志文章,评审


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    更新日期:1999-12-01 00:00:00

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    pub_type: 杂志文章


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    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

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    更新日期:2011-12-01 00:00:00

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

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    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章,随机对照试验


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    更新日期:2018-06-01 00:00:00

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    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...

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    pub_type: 临床试验,杂志文章


    authors: Blier P,Bergeron R

    更新日期:1995-06-01 00:00:00

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    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...

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    pub_type: 杂志文章,评审


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    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


    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

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    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


    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.

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    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章,评审


    authors: Ernst CL,Goldberg JF

    更新日期:2003-04-01 00:00:00

  • Ongoing lithium treatment prevents relapse after total sleep deprivation.

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    journal_title:Journal of clinical psychopharmacology

    pub_type: 临床试验,杂志文章


    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.

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    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章


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

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    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


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

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  • Psychiatric reactions during tricyclic treatment of the elderly reconsidered.

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    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章


    authors: Meyers BS,Mei-Tal V

    更新日期:1983-02-01 00:00:00

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    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章


    authors: Nelson JC,Jatlow PI,Mazure C

    更新日期:1985-08-01 00:00:00

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    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章,meta分析,评审


    authors: Ducharme LJ,Knudsen HK,Roman PM

    更新日期:2006-12-01 00:00:00

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    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章


    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

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    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章


    authors: Rothschild AJ

    更新日期:1985-12-01 00:00:00

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    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


    authors: Lin HS,Wang FC,Lin CH

    更新日期:2015-12-01 00:00:00

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    journal_title:Journal of clinical psychopharmacology

    pub_type: 杂志文章


    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