Table G-40Paroxetine compared with desiprimine: Head-to-head trialsa

Domains Pertaining to Strength of EvidenceMagnitude of EffectStrength of Evidence
Number of Studies; Number of SubjectsRisk of Bias; DesignConsistencyDirectnessPrecisionSummary Effect Size (95% CI)High, Moderate, Low, Insufficient
PTSD Symptom Reduction: CAPS, mean change from baseline
1; 88Medium; RCTNA, single studyDirectImprecise−33.5 vs. −33.2 vs. −35.7 vs. −36.4, p=NSaLow
Remission (no longer having symptoms)
0; 0NANANANANAInsufficient
Loss of Diagnosis
0; 0NANANANANAInsufficient
Prevention/reduction of comorbid depression: HAMD, mean change from baseline
1; 88Medium; RCTNA, single studyDirectImprecise−3.9 vs. −2.7 vs. −2.6 vs. −4.2, p=NSaLow
Prevention/reduction of comorbid alcohol dependence: heavy drinking days and drinks per drinking day
1; 88Medium; RCTNA, single studyDirectImpreciseGreater reduction with desipraminebLow
Quality of Life
0; 0NANANANANAInsufficient
Disability/functional impairment
0; 0NANANANANAInsufficient
Return to work or return to active duty
0; 0NANANANANAInsufficient
a

Data are from 1 trial of veterans with PTSD and comorbid alcohol dependence that compared Paroxetine + Naltrexone, Paroxetine + Placebo, Desiprimine + Naltrexone, and Desipramine + Placebo.

b

Data NR for drinking outcomes; p=0.009 for percentage of heavy drinking days and p=0.027 for drinks per drinking day; shown in Figure only; magnitude of difference NR and difficult to read clearly from the Figure, all groups ended up less than 20 standard drinks per week (from baselines above 70 drinks per week), but it appears that the Desipramine groups ended up in the 0 to 10 drinks per week range and the paroxetine groups ended up in the 10–20 range at the 12 week endpoint.

Abbreviations: CI = confidence interval; NA = not applicable; NR = not reported; RCT = randomized controlled trial

From: Appendix G, Strength of Evidence

Cover of Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder (PTSD)
Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder (PTSD) [Internet].
Comparative Effectiveness Reviews, No. 92.
Jonas DE, Cusack K, Forneris CA, et al.

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