Escitalopram versus paroxetine controlled release in major depressive disorder: a randomized trial

Figures & data

Table 1 Baseline characteristics of the patients

Variable	Escitalopram (n=43)	Paroxetine controlled release (n=45)	Group difference (χ^2 test or t-test)	P-value
Male (%)	25 (58.1)	29 (64.4)	χ^2=0.369	0.544
Age, years (mean ± SD)	38.9±12.4	42.5±14.2	t=−1.28	0.205
First episode (%)	35 (81.4)	33 (73.3)	χ^2=0.819	0.366
Educational history, years (mean ± SD)	14.0±1.88	13.6±2.22	t=−0.752	0.454
Hospitalization (%)	0 (0.00)	1 (2.22)	χ^2=1.35	0.245
Study center (FHU hospital, %)	19 (44.2)	26 (57.8)	χ^2=1.63	0.202
Married (%)	25 (58.1)	19 (42.2)	χ^2=2.24	0.135
Unemployed (%)	8 (18.6)	12 (26.7)	χ^2=0.819	0.366
Current smoker (%)	9 (20.9)	9 (20.0)	χ^2=0.012	0.914
Hamilton Depression Rating Scale-17 total scores (mean ± SD)	23.7±3.58	23.2±3.78	t=−0.605	0.547
Hamilton Depression Rating Scale-21 total scores (mean ± SD)	25.8±4.24	25.1±4.71	t=−0.710	0.480
Comorbid psychiatric illness (%)*	6 (14.0)	6 (13.3)	χ^2=0.007	0.933
Body weight, kg (mean ± SD)	65.0±13.9	65.7±12.3	t=0.240	0.811
Use of antidepressant (%)	0 (0.00)	0 (0.00)	Not applicable
Use of hypnotic (%)	6 (14.0)	6 (13.3)	χ^2=0.007	0.933
Use of anxiolytic (%)	0 (0.00)	1 (2.22)	χ^2=1.35	0.245

Note:

* Generalized anxiety disorder and/or panic disorder.

Abbreviations: FHU, Fujita Health University; SD, standard deviation.

Table 2 Discontinuation rate

Number of patients	Escitalopram	Paroxetine controlled release
Randomized	43	45
Completed the trial (%)	19 (44.2)	18 (40.0)
Discontinued the trial (%)	24 (55.8)	27 (60.0)
The reasons of discontinuation
Inefficacy (%)	9 (20.9)	8 (17.8)
Adverse events (%)	8 (18.6)	11 (24.4)
Other reasons (%)	7 (16.2)	8 (17.8)

Figure 1 Response rate.

Abbreviations: CR, controlled release; HAMD, Hamilton Depression Rating Scale.

Figure 2 Remission rate.

Abbreviations: CR, controlled release; HAMD, Hamilton Depression Rating Scale.

Table 3 Group difference in Hamilton Depression Rating Scale scores at 2, 4, 8, 12, and 24 weeks

	Baseline score	Change in score at 2 weeks	Fdf, P-value	Change in score at 4 weeks	Fdf, P-value	Change in score at 8 weeks	Fdf, P-value	Change in score at 12 weeks	Fdf, P-value	Change in score at 24 weeks	Fdf, P-value
Hamilton Depression Rating Scale-17 total scores
Escitalopram	23.7±3.58	−9.40±6.57	F1.86=2.00, 0.161	−12.0±7.01	F1.86=1.92, 0.169	−12.8±7.36	F1.86=1.03, 0.314	−13.4±7.56	F1.86=2.58, 0.112	−14.5±7.73	F1.86=3.10, 0.082
Paroxetine controlled release	23.2±3.78	−7.11±7.26		−9.58±7.76		−10.9±7.62		−10.6±7.86		−11.4±7.84
Hamilton Depression Rating Scale-21 total scores
Escitalopram	25.8±4.24	−10.0±7.18	F1.86=1.62, 0.206	−12.6±8.01	F1.86=1.25, 0.267	−13.8±8.01	F1.86=0.775, 0.381	−15.3±7.75	F1.86=3.07, 0.084	−15.6±8.16	F1.86=1.02, 0.315
Paroxetine controlled release	25.1±4.71	−7.69±7.93		−10.3±8.63		−12.0±8.42		−12.0±8.98		−13.4±9.38

Notes: Covariate: Hamilton Depression Rating Scale score at baseline. Data presented as mean ± standard deviation.

Abbreviation: df, degrees of freedom.

Table 4 Adverse events observed in the study (incidence ≥5%)

Individual adverse events	Escitalopram (n=43)	Paroxetine controlled release (n=45)	Group difference (χ^2 test or analysis of covariance and P-value
At least one adverse event (%)	26 (60.5)	29 (64.4)	χ^2=0.149 and 0.700
Headache (%)	5 (11.6)	2 (4.44)	χ^2=1.59 and 0.207
Somnolence (%)	12 (27.9)	8 (17.8)	χ^2=1.29 and 0.256
Dizziness (%)	6 (14.0)	4 (8.89)	χ^2=0.562 and 0.453
Anxiety (%)	9 (20.9)	4 (8.89)	χ^2=2.58 and 0.108
Insomnia (%)	6 (14.0)	5 (11.1)	χ^2=0.162 and 0.687
Decreased salivation (%)	3 (6.98)	5 (11.1)	χ^2=0.460 and 0.498
Nausea/vomiting (%)	11 (25.6)	12 (26.7)	χ^2=0.013 and 0.908
Diarrhea (%)	9 (20.9)	6 (13.3)	χ^2=0.901 and 0.342
Constipation (%)	6 (14.0)	3 (6.67)	χ^2=1.29 and 0.256
Loss of sexual desire (%)	2 (4.65)	3 (6.67)	χ^2=0.168 and 0.682
Use of hypnotic (%)	6 (14.0)	6 (13.3)	χ^2=0.007 and 0.933
Use of anxiolytic (%)	0 (0.00)	1 (2.22)	χ^2=1.35 and 0.245
Weight gain (%)	1 (2.33)	3 (6.67)	χ^2=1.00 and 0.317
Mean weight change (kg)*	0.853±3.05	0.502±2.11	F1.86 =0.471 and 0.494

Notes:

* Covariate: body weight at baseline. Data presented as mean ± standard deviation.

Table S1 Endpoint change in Hamilton Depression Rating Scale scores at 2, 4, 8, 12, and 24 weeks from the baseline

Mean score at baseline	Mean score at 2 weeks	tdf, P-value	Mean score at 4 weeks	tdf, P-value	Mean score at 8 weeks	tdf, P-value	Mean score at 12 weeks	tdf, P-value	Mean score at 24 weeks	tdf, P-value
Hamilton Depression Rating Scale-17 total score: escitalopram
23.7±3.58	14.3±5.97	t42=−9.38, <0.0001	11.7±6.37	t42=−11.2, <0.0001	10.9±6.71	t42=−11.4, <0.0001	10.3±7.00	t42=−11.6, <0.0001	9.23±7.24	t42=−12.3, <0.0001
Hamilton Depression Rating Scale-17 total scores: paroxetine controlled release
23.2±3.78	16.1±7.09	t44=−6.57, <0.0001	13.6±7.63	t44=−8.28, <0.0001	12.3±7.64	t44=−9.61, <0.0001	12.6±7.67	t44=−9.03, <0.0001	11.4±7.86	t44=−9.72, <0.0001
Hamilton Depression Rating Scale-21 total scores: escitalopram
25.8±4.24	15.7±6.53	t42=−9.15, <0.0001	13.2±7.41	t42=−10.3, <0.0001	12.0±7.58	t42=−11.3, <0.0001	10.4±7.76	t42=−13.0, <0.0001	10.1±7.97	t42=−12.6, <0.0001
Hamilton Depression Rating Scale-21 total scores: paroxetine controlled release
25.1±4.71	17.4±8.25	t44=−6.50, <0.0001	14.8±8.82	t44=−8.00, <0.0001	13.1±8.79	t44=−9.55, <0.0001	13.1±9.27	t44=−8.95, <0.0001	11.6±9.62	t44=−9.61, <0.0001

Note: Data presented as mean ± standard deviation.

Abbreviation: df, degrees of freedom.