DOSE-RESPONSE EFFICACY OF PAROXETINE IN PREVENTING DEPRESSIVE RECURRENCES - A RANDOMIZED, DOUBLE-BLIND-STUDY

Background: The authors evaluated and compared the efficacy of 20 mg v ersus 40 mg of paroxetine in a randomized, double-blind, parallel-grou p study during a maintenance period of 28 months. Method: Ninety-nine inpatients with recurrent, unipolar depression (DSM-IV criteria) who h ad at least 1 depressive episode during the 18 months preceding the in dex episode were openly treated with paroxetine 40 mg/day. Seventy-two subjects had a stable response (Hamilton Rating Scale for Depression score < 8) to paroxetine treatment and remained in the continuation tr eatment as outpatients for 4 months. At the time of recovery, 68 patie nts were randomly assigned to 1 of the 2 maintenance treatment groups: paroxetine 20 mg or paroxetine 40 mg daily. Results: Sixty-seven pati ents completed the 28-month follow-up period. Seventeen (51.5%) of 33 patients in the 20-mg paroxetine regimen had a single recurrence compa red with 8 (23.5%) of 34 subjects in the 40-mg dose regimen (chi(2) = 5.56, p = .018). Conclusion: These data suggest that a full dose of pa roxetine is recommended in unipolar patients who are at high risk for recurrent depressive episodes.