Clinical overview of serotonin re-uptake inhibitors

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Abstract
The SSRIs are a new class of effective antidepressant agents which have proven efficacy in a wide range of psychiatric applications. They are as effective as the tricyclic antidepressants and are better tolerated. The SSRIs are safe in overdose and have minimal drug interactions, and are suitable for once-daily dosing. Newer members of the class, such as paroxetine have shorter half-lives and no active metabolites and are likely to be safer than other members of the class. Paroxetine has been compared with the standard tricyclic antidepressants in a range of studies, and the efficacy and tolerability data from these studies have been collected together in the worldwide database on paroxetine. Paroxetine was shown to be at least as effective as placebo and active comparators in melancholic depression (DSM-III). In a comparative study of paroxetine and fluoxetine, both drugs were effective in reducing depressive symptoms and paroxetine showed a faster onset of action than fluoxetine. A higher incidence of side-effects was obtained in fluoxetine patients. In a long-term comparative study of paroxetine and placebo fewer patients relapsed while on paroxetine for one year than on placebo - 15 and 38%, respectively.