Objective The literature has shown that cognitive and emotional changes may occur after chronic treatment with glucocorticoids. This might be caused by the suppressive effect of glucocorticoids on hippocampal neurogen...Objective The literature has shown that cognitive and emotional changes may occur after chronic treatment with glucocorticoids. This might be caused by the suppressive effect of glucocorticoids on hippocampal neurogenesis and cell proliferation. Paroxetine, a selective serotonin reuptake transporter, is a commonly used antidepressant for alleviation of signs and symptoms of clinical depression. It was discovered to promote hippocampal neurogenesis in the past few years and we wanted to investigate its interaction with glucocorticoid in this study. Methods Adult rats were given vehicle, corticosterone, paroxetine, or both corticosterone and paroxetine for 14 d. Cell proliferation in the dentate gyrus was quantified using 5-bromo-2-deoxyuridine （BrdU） immunohistochemistry. Results The corticosterone treatment suppressed while paroxetine treatment increased hippocampal cell proliferation. More importantly, paroxetine treatment could reverse the suppressive effect of corticosterone on hippocampal cell proliferation. Conclusion This may have clinic application in preventing hippocampal damage after glucocorticoid treatment.展开更多
Dapoxetine hydrochloride is a selective serotonin reuptake inhibitor and the first drug approved for the on-demand treatment of premature ejaculation （PE）, Our objective in this study was to characterize the efficac...Dapoxetine hydrochloride is a selective serotonin reuptake inhibitor and the first drug approved for the on-demand treatment of premature ejaculation （PE）, Our objective in this study was to characterize the efficacy of on-demand dapoxetine （30 and 60 mg） and daily paroxetine （20 mg） usage in treating PE, We conducted a 1 month study involving a total of 150 patients. Patients were divided into three groups of 50, Group 1 were treated with on-demand dapoxetine （30 mg）, Group 2 with on-demand dapoxetine （60 mg） and Group 3 with daily paroxetine （20 rag）, Our outcome measurement was increased from baseline intravaginal ejaculatory latency time （IELT） after treatment, The IELT increased from baseline to posttreatment by 117%, 117% and 170% in the paroxetine group （P 〈 0,01）, 30 mg dapoxetine group （P 〈 0,01） and 60 mg dapoxetine group （P 〈 0.01）, respectively, The increase from baseline IELT were similar for the 30 mg dapoxetine and paroxetine groups （P 〉 0,05）, while the 60 mg dapoxetine group had a larger posttreatment IELT increase compared with the 30 mg dapoxetine （P〈 0.05） and paroxetine （P〈 0.01） groups, Dapoxetine （60 mg） 1-3 h before planned intercourse is a very effective treatment modality for PE. However, an on-demand dose of 30 mg dapoxetine is no more effective than the currently prescribed paroxetine treatment.展开更多
In this study, a model of migraine was established by electrical stimulation of the superior sagittal sinus in rats. These rats were then treated orally with paroxetine at doses of 2.5, 5, or 10 mg/kg per day for 14 d...In this study, a model of migraine was established by electrical stimulation of the superior sagittal sinus in rats. These rats were then treated orally with paroxetine at doses of 2.5, 5, or 10 mg/kg per day for 14 days. Following treatment, mechanical withdrawal thresholds were significantly higher, extracellular concentrations of 5-hydroxytryptamine in the periaqueductal grey matter and nucleus reticularis gigantocellularis were higher, and the expression of phosphorylated p38 in the trigeminal nucleus caudalis was lower. Our experimental findings suggest that paroxetine has analgesic effects in a rat migraine model, which are mediated by inhibition of p38 phosphorylation.展开更多
Depressed patients with scores of 17 or more on the 17 items of the Hamilton Depression Rating Scale were treated with the antidepressant drug paroxetine. They also underwent verum acupuncture or electroacupuncture at...Depressed patients with scores of 17 or more on the 17 items of the Hamilton Depression Rating Scale were treated with the antidepressant drug paroxetine. They also underwent verum acupuncture or electroacupuncture at Baihui （GV20） and Yintang （GV29）. The World Health Organization Quality of Life Scale Brief Version showed a significant increase in the total scores of patients who underwent verum acupuncture and electroacupuncture for 6 weeks compared with those who were given paroxetine only; significantly increased physical domain and social relationship scores in verum acupuncture patients compared with paroxetine only; and significantly elevated psychological domain scores with electroacupuncture compared with paroxetine only. These results indicate that both verum acupuncture and electroacupuncture can improve quality of life in depressed patients undergoing paroxetine treatment,展开更多
Despite progressive improvement in treating major depressive disorder (MDD), it remains mostly unresponsive to one antidepressant medication. Zinc is a brain highly abundant trace metal, a brain derived neurotrophic f...Despite progressive improvement in treating major depressive disorder (MDD), it remains mostly unresponsive to one antidepressant medication. Zinc is a brain highly abundant trace metal, a brain derived neurotrophic factor (BDNF) inducer, a modulator of synaptic plasticity and potent suppressor of the NMDA receptors. We proposed that co-administration of zinc with the antide-pressants may represent a valuable regimen to improve the efficacy of these drugs. This work has been implemented to evaluate the behavioral changes of acute and sub-acute co-administration of zinc with Paroxtine in mice. Methods: The animals were injected intra-peritoneal with either Paroxtine (20 mg/kg) which was a selective serotonin reuptake inhibitor (SSRI), zinc sulfate (30 mg/kg) or Paroxtine in combination with zinc for one day and one week (once daily). The pattern of the animal behavior was assessed in the forced swim test (FST). Results and Discussion: The behavioral patterns of the animals in the FST include immobility, swimming and climbing. Successful antidepressant should decrease the immobility time with either increase in swimming and/or climbing behavior based on the drug pharmacological activity. Our results revealed a significant decrease of immobility and increase of swimming behavior indicating serotonin-dependent pharmacological activity of Paroxtine or zinc alone as well as in the animals treated with zinc in combination with Paroxtine. There was no significant difference in the animals’ behavior between acute and sub-acute treatment with zinc or even upon its addition to paroxetine. Our data support the concept that co-administration of zinc may provide further antidepressant activity. Zinc may offer additional clinical value particularly in geriatric patients or other populations where zinc level has shown dramatic decrease.展开更多
AIM: To compare the effectiveness and tolerability of paroxetine vs pregabalin for the management of multiple sclerosis(MS)-induced neuropathic pain(NPP).METHODS: A randomized, flexible-dose open-label 8-wk study invo...AIM: To compare the effectiveness and tolerability of paroxetine vs pregabalin for the management of multiple sclerosis(MS)-induced neuropathic pain(NPP).METHODS: A randomized, flexible-dose open-label 8-wk study involving 21 relapsing-remitting MS patients with MS-induced NPP was conducted to evaluate the effectiveness and tolerability of pregabalin versus paroxetine for pain management. The trial included a 3-wk dose titration phase followed by a 5-wk stable dose phase. Primary outcome measures included daily patient-reported pain intensity as measured using a 100 mm visual analogue scale(VAS pain) and daily impact of pain on daily activities(VAS impact). Hierarchical regression modeling was conducted on each outcome to determine if within person VAS trajectory for pain and impact differed across study groups, during 56 d follow-up. RESULTS: Attrition rates were significantly greater(P < 0.001) in the paroxetine versus pregabalin study group(70% vs 18.2%, respectively). Average study duration between study groups also significantly differed(P < 0.001). Paroxetine participants completed an average of 27.3 d of treatment vs 49.5 d in the pregabalin group, with the majority of patients withdrawing due to adverse events. Due to the high attrition rates in the paroxetine study arm, the investigators stopped the study prior to achieving complete recruitment. As such, no significant differences between pregabalin and paroxetine study arms were noted for the primary outcome measures(VAS pain, VAS impact). Comparative assessment of baseline patient characteristics also revealed no significant differences between the study arms. CONCLUSION: High attrition rates associated with paroxetine use suggest that it be used with caution for MS-induced NPP. Efficacy outcomes could not be assessed due to attrition.展开更多
Paroxetine is a selective serotonin reuptake inhibitor(SSRI)used in the treatment of depression and anxiety disorders.In some epidemiological studies,slightly increased risks of major malformations and cardiac malform...Paroxetine is a selective serotonin reuptake inhibitor(SSRI)used in the treatment of depression and anxiety disorders.In some epidemiological studies,slightly increased risks of major malformations and cardiac malformations have been reported following paroxetine exposure in the first trimester of pregnancy.However,such findings have been inconsistent.There is only one report of any overdose of an SSRI during pregnancy,and that involved escitalopram.The aim of this case report was to describe the impact of a paroxetine overdose in the first trimester of pregnancy on the health of the foetus.A 21-year-old mother of one child who was pregnant with a second child was prescribed 20 mg/day paroxetine hydrochloride for the treatment of anxiety/depression.The patient ingested 15 or 1620-mg tablets of paroxetine hydrochloride(300-320 mg)during the 5th week of pregnancy as a suicide attempt.Within 15 min of ingestion,she was admitted to hospital and treated for intoxication.No evidence of maternal SSRI intoxication was observed after treatment.The patient consulted our teratology information service for further risk assessment regarding possible major congenital malformations following the paroxetine overdose.We were unable to find previous reports of paroxetine overdose during pregnancy in the literature.The timely administration of the overdose treatment and the lack of maternal intoxication symptoms were considered positive for the foetal well-being,and the patient was referred for perinatology and psychiatry follow-ups.A healthy,3500-g male infant was born at 38 weeks’gestation,and his development at the age of 2 years was normal.This is the first reported case of paroxetine overdose during pregnancy.Comprehensive studies are needed to evaluate pregnancy outcomes after SSRI overdose.展开更多
To study the effect of paroxetine on depressive symptom accompanying somatic disease and the value of platelet 5-HT concentration in the diagnosis of depression, 30 patients with depressive symptom were treated with ...To study the effect of paroxetine on depressive symptom accompanying somatic disease and the value of platelet 5-HT concentration in the diagnosis of depression, 30 patients with depressive symptom were treated with paroxetine. All patients were evaluated on Zung and HAMD scale and assayed of platelet 5-HT concentration before and after treatment. It was found that patients had a lower level of platelet 5-HT concentration than healthy people (P<0.01). After six weeks of treatment, depressive and somatic symptoms were both improved (P<0.01) and platelet 5-HT concentration was even lower (P>0.05). It was suggested that paroxetine was a good antidepressant and platelet 5-HT concentration was useful in the screening of depression.展开更多
The prevalence of persons with social anxiety disorder (SAD) in Japan remains unknown. This study examined 293 patients with age between 20 and 60 at first visit on the outpatient clinic of psychiatry by the section o...The prevalence of persons with social anxiety disorder (SAD) in Japan remains unknown. This study examined 293 patients with age between 20 and 60 at first visit on the outpatient clinic of psychiatry by the section of social phobia of M.I.N.I. and DSM-IV. After that, 10 patients with both SAD out of 16 patients (trial recruited) completed 12 weeks of treatment with paroxetine. Among 63 patients with 4 points and 40 patients with 3 points on the M.I.N.I., 21 patients (33%) and 16 patients (40%) were diagnosed as SAD on DSM-IV criteria, respectively. Together, 37 patients (12.6%) were diagnosed as SAD out of the 293 outpatients. Among 37 patients with SAD, 23 patients (62%) had comorbid depression. As for 10 patients after treatment with paroxetine, 8 patients improved from the point of recovery of depression (HAM-D scores below 10), whereas only 4 patients improved from the point of recovery of social phobia (L-SAS scores below 30). Three points as well as 4 points on the M.I.N.I. is meaningful for the diagnosis of SAD. For a while, paroxetine exerted less beneficial effects on SAD rather than on depression.展开更多
OBJECTIVE: Neurocardiogenic syncope (NCS) is a condition where the patient has a temporary loss of consciousness or feelings of weakness and fatigue. There are triggers such as prolonged sitting or standing, pain, and...OBJECTIVE: Neurocardiogenic syncope (NCS) is a condition where the patient has a temporary loss of consciousness or feelings of weakness and fatigue. There are triggers such as prolonged sitting or standing, pain, and heavy exercise, but often episodes are random. Treatments are limited and the use of specific serotonin reuptake inhibitors (SSRI) have had mixed results, but a limited number of studies have suggested that paroxetine may be effective in improving the symptoms of NCS. METHODS: This is a single case report of a 20-year old female who was diagnosed with NCS by a tilt test and treated conservatively with increased fluid and salt intake, and counter-pressure maneuvers. She was given one dose of sertraline, but immediately experienced disturbing visual images. She presented at the Depression Center with moderate depressive symptoms and was started on paroxetine and given cognitive/behavioral strategies to manage the NCS. RESULTS: Since the patient had a negative experience with a prior SSRI, she was started on a low dose of paroxetine and omega-3 fatty acids. She also was given a detailed explanation of NCS and a number of cognitive/behavioral strategies such as deep breathing, progressive relaxation, imagery, and sleep. CONCLUSION: After 2-weeks of the multi-faceted treatment approach, she had a significant decrease in her depressive symptoms. After 6-months, the patient had no episodes of syncope and no depressive symptoms. She was able to stand for long periods and exercise without feelings of weakness and fatigue. A multimodal approach may offer the best treatment strategy to achieve full remission in patients with NCS.展开更多
The mechanism(s) of analgesic action of paracetamol (acetaminophen;N-acetyl-p-aminophenol) remains controversial. Previous studies on rats suggested that the antinociceptive action of paracetamol might involve the cen...The mechanism(s) of analgesic action of paracetamol (acetaminophen;N-acetyl-p-aminophenol) remains controversial. Previous studies on rats suggested that the antinociceptive action of paracetamol might involve the central descending inhibitory pain pathways recruiting both a serotoninergic and an opioidergic system. This study explores this issue in mice using paroxetine, the most potent selective serotonin re-uptake inhibitor, and the nonselective opioid pure antagonist naloxone. Animals were divided into two main groups for two separate experiments, each subdivided into 3 subgroups. In both experiments;the first group served as control, the second group received paracetamol (200 mg/kg, i.p). In one experiment, the third group received paroxetine (20 mg/kg p.o for 7 days) before paracetamol. In the other experiment, animals of the third group were pretreated with naloxone (5 mg/kg, i.p) 30 min before paracetamol. The antinociceptive effect of paracetamol was tested using the hot plate test. Paracetamol displayed a significant antinociceptive activity that was augmented by pretreatment with paroxetine as was shown by maintenance of its effect beyond that shown by paracetamol alone. On the other hand, pretreatment with naloxone abolished paracetamol’s antinociceptive activity in the hot-plate test. These results extended the previous observation in rats that the antinociceptive effect of paracetamol involved activation of a central descending pain inhibitory pathway with serotonin and opioidergic peptides being potential mediators recruited.展开更多
Objective: to compare the safety of escitalopram and paroxetine in the treatment of senile depression. Methods: in this study, 82 patients with senile depression from November 2018 to June 2020 were selected for analy...Objective: to compare the safety of escitalopram and paroxetine in the treatment of senile depression. Methods: in this study, 82 patients with senile depression from November 2018 to June 2020 were selected for analysis. They were divided into control group and observation group according to the order of admission, and were treated with paroxetine and escitalopram respectively. The curative effect, adverse reactions, symptom improvement and satisfaction of the two groups were compared. Results: the effective rate was 97.56%(40 cases) in the observation group and 95.12%(39 cases) in the control group, with no significant difference between the two groups (P > 0.05). The incidence of adverse reactions in the observation group was 4.88%(2 cases), which was lower than that in the control group (19.51%, 8 cases). There was significant difference between the two groups (P < 0.05). Before the treatment, the HADM scores and SDS scores of each group were counted, and the depressive symptoms were evaluated. After the scores were calculated, there was no difference between the observation group and the control group, P > 0.05. After the second and fourth weeks of treatment, the HADM scores and SDS scores of each group were counted. After evaluating the depressive symptoms, the scores in the observation group were lower than those in the control group (P < 0.05). At the eighth week of treatment, the HADM scores and SDS scores of each group were counted, and the depressive symptoms were evaluated. After the scores were calculated, there was no difference between the observation group and the control group, P > 0.05. After counting the satisfaction data of each group, it reached 92.68% in the observation group, which was higher than 75.61% in the control group, with significant differences between groups (P < 0.05). Conclusion: the treatment outcome of escitalopram and paroxetine in the treatment of senile depression patients is equivalent, and both can achieve ideal curative effect, but the former has fast effect and less adverse reactions, which can improve patient compliance, and is more feasible.展开更多
Objective: to explore the clinical efficacy of paroxetine in the treatment of patients with depression and anxiety disorder after ischemic stroke. Methods: 80 patients with depression and anxiety disorder after ischem...Objective: to explore the clinical efficacy of paroxetine in the treatment of patients with depression and anxiety disorder after ischemic stroke. Methods: 80 patients with depression and anxiety disorder after ischemic stroke were randomly divided into two groups. One group was the control group with routine treatment, and the other group was additionally treated with paroxetine. Each group contained 40 patients, and the treatment conditions of the two groups were observed. Results: compared with the control group, the effective rate of the study group was higher (P < 0.05). Before and after treatment, the emotional state, sleep quality and neurotransmitter level of the study group improved more significantly, P < 0.05. Conclusion: paroxetine is helpful to improve the emotional state and sleep quality of patients with depression and anxiety disorder after ischemic stroke, and it is worth popularizing.展开更多
Background:G protein-coupled receptor kinase 2(GRK2)could participate in the regulation of diverse cells via interacting with non-G-protein-coupled receptors.In the present work,we explored how paroxetine,a GRK2 inhib...Background:G protein-coupled receptor kinase 2(GRK2)could participate in the regulation of diverse cells via interacting with non-G-protein-coupled receptors.In the present work,we explored how paroxetine,a GRK2 inhibitor,modulates the differentiation and activation of immune cells in rheumatoid arthritis(RA).Methods:The blood samples of healthy individuals and RA patients were collected between July 2021 and March 2022 from the First Affiliated Hospital of Anhui Medical University.C57BL/6 mice were used to induce the collagen-induced arthritis(CIA)model.Flow cytometry analysis was used to characterize the differentiation and function of dendritic cells(DCs)/T cells.Co-immunoprecipitation was used to explore the specific molecular mechanism.Results:In patients with RA,high expression of GRK2 in peripheral blood lymphocytes,accompanied by the increases of phosphatidylinositol 3 kinase(PI3K),protein kinase B(AKT),and mammalian target of rapamycin(mTOR).In animal model,a decrease in regulatory T cells(T regs),an increase in the cluster of differentiation 8 positive(CD8+)T cells,and maturation of DCs were observed.Paroxetine,when used in vitro and in CIA mice,restrained the maturation of DCs and the differentiation of CD8+T cells,and induced the proportion of T regs.Paroxetine inhibited the secretion of pro-inflammatory cytokines,the expression of C-C motif chemokine receptor 7 in DCs and T cells.Simultaneously,paroxetine upregulated the expression of programmed death ligand 1,and anti-inflammatory cytokines.Additionally,paroxetine inhibited the PI3K-AKT-mTOR metabolic pathway in both DCs and T cells.This was associated with a reduction in mitochondrial membrane potential and changes in the utilization of glucose and lipids,particularly in DCs.Paroxetine reversed PI3K-AKT pathway activation induced by 740 Y-P(a PI3K agonist)through inhibiting the interaction between GRK2 and PI3K in DCs and T cells.Conclusion:Paroxetine exerts an immunosuppressive effect by targeting GRK2,which subsequently inhibits the metabolism-related PI3K-AKT-mTOR pathway of DCs and T cells in RA.展开更多
BACKGROUND Post-stroke depression(PSD)is associated with hypothalamic-pituitary-adrenal(HPA)axis dysfunction and neurotransmitter deficits.Selective serotonin reuptake inhibitors(SSRIs)are commonly used,but their effi...BACKGROUND Post-stroke depression(PSD)is associated with hypothalamic-pituitary-adrenal(HPA)axis dysfunction and neurotransmitter deficits.Selective serotonin reuptake inhibitors(SSRIs)are commonly used,but their efficacy is limited.This study investigated whether combining SSRIs with traditional Chinese medicine(TCM)Free San could enhance their therapeutic effects.AIM To evaluate the clinical efficacy and safety of combining SSRIs with Free San in treating PSD,and to assess its impact on HPA axis function.METHODS Ninety-two patients with PSD were enrolled and randomly divided into control groups(n=46)and study groups(n=46).The control group received the SSRI paroxetine alone,whereas the study group received paroxetine combined with Free San for 4 weeks.Hamilton Depression Scale and TCM syndrome scores were assessed before and after treatment.Serum serotonin,norepinephrine,cortisol,cor-ticotropin-releasing hormone,and adrenocorticotropic hormone were measured.The treatment responses and adverse reactions were recorded.RESULTS After treatment,the Hamilton Depression Scale and TCM syndrome scores were significantly lower in the study group than in the control group(P<0.05).Serum serotonin and norepinephrine levels were significantly higher in the study group than in the control group,whereas cortisol,corticotropin-releasing hormone,and adrenocorticotropic hormone levels were significantly lower(P<0.05).The total efficacy rates were 84.78%and 65.22%in the study and control groups,respectively(P<0.05).No significant differences in adverse reactions were observed between the two groups(P>0.05).CONCLUSION Combining SSRIs with Free San can enhance therapeutic efficacy,improve depressive symptoms,and regulate HPA axis function in patients with PSD with good safety and clinical application value.展开更多
Background The neurogenesis in retina of adult mammals is generally abolished, and this renders the retina lack of regenerative capacity. Despite this, there is a small population of nestin-positive cells in the cilia...Background The neurogenesis in retina of adult mammals is generally abolished, and this renders the retina lack of regenerative capacity. Despite this, there is a small population of nestin-positive cells in the ciliary epithelium which retains neurogenic potential. The present study aimed at investigating the effect of two drugs, corticosterone and paroxetine, on the cell proliferation of the ciliary body. Methods Adult Sprague-Dawley rats were given vehicle, corticosterone, paroxetine, or both corticosterone and paroxetine treatment for 14 days. Cell proliferation in the ciliary body was quantified using 5-bromo-2-deoxyuridine （BrdU） immunohistochemistry. Co-labelling of BrdU and stem cell marker was used to phenotype the BrdU immunoreactive cells. Results Corticosterone treatment suppressed while paroxetine treatment increased the cell proliferation of the ciliary body. Co-labelling with cell markers revealed that the BrdU positive cells also showed nestin expression but not glial fJbrillary acidic protein （GFAP）. Conclusions The results illustrate that proliferation of retinal progenitor cells situated in ciliary body are subjected to regulation by selective serotonin reuptake Jnhibitors （SSRI） and corticosteroJd, which is similar to our previous findings in neurogenic regions in central nervous system （CNS）. Paroxetine treatment could reverse the suppressive effect of corticosterone on ciliary body cell proliferation. This provides information for future investigation of retinal stem cell biology and potential treatment of retinal degenerative diseases.展开更多
Objective： To observe the clinical efficacy and adverse reactions of Paroxetine combined with electro-acupuncture （EA） in treating depression. Methods： Forty-two patients with depression were randomly assigned to ...Objective： To observe the clinical efficacy and adverse reactions of Paroxetine combined with electro-acupuncture （EA） in treating depression. Methods： Forty-two patients with depression were randomly assigned to the observation group （22 patients） treated with EA combined with Paroxetine, and the control group （20 patients） treated with Paroxetine alone, and the therapeutic course for both groups was 6 weeks. The therapeutic efficacy and adverse reactions were evaluated with scores by Hamilton depression scale （HAMD） and treatment emergent symptoms scale （TESS）, respectively. Results： HAMD scores determined at the end of the 1st, 2nd, 4th, and 6th week of the treatment course were significantly lower in the observation group than those in the control group （P〈0.05）. The significant improvement rate evaluated at the end of the 6-week treatment was remarkably higher in the observation group than that in the control group （72.7% vs 40.0%）. No significant difference of TESS scores was found between the two groups. Conclusion： EA combined with Paroxetine has better clinical efficacy than that of Paroxetine alone, with milder adverse reaction and quicker initiation of effect.展开更多
文摘Objective The literature has shown that cognitive and emotional changes may occur after chronic treatment with glucocorticoids. This might be caused by the suppressive effect of glucocorticoids on hippocampal neurogenesis and cell proliferation. Paroxetine, a selective serotonin reuptake transporter, is a commonly used antidepressant for alleviation of signs and symptoms of clinical depression. It was discovered to promote hippocampal neurogenesis in the past few years and we wanted to investigate its interaction with glucocorticoid in this study. Methods Adult rats were given vehicle, corticosterone, paroxetine, or both corticosterone and paroxetine for 14 d. Cell proliferation in the dentate gyrus was quantified using 5-bromo-2-deoxyuridine （BrdU） immunohistochemistry. Results The corticosterone treatment suppressed while paroxetine treatment increased hippocampal cell proliferation. More importantly, paroxetine treatment could reverse the suppressive effect of corticosterone on hippocampal cell proliferation. Conclusion This may have clinic application in preventing hippocampal damage after glucocorticoid treatment.
文摘Dapoxetine hydrochloride is a selective serotonin reuptake inhibitor and the first drug approved for the on-demand treatment of premature ejaculation （PE）, Our objective in this study was to characterize the efficacy of on-demand dapoxetine （30 and 60 mg） and daily paroxetine （20 mg） usage in treating PE, We conducted a 1 month study involving a total of 150 patients. Patients were divided into three groups of 50, Group 1 were treated with on-demand dapoxetine （30 mg）, Group 2 with on-demand dapoxetine （60 mg） and Group 3 with daily paroxetine （20 rag）, Our outcome measurement was increased from baseline intravaginal ejaculatory latency time （IELT） after treatment, The IELT increased from baseline to posttreatment by 117%, 117% and 170% in the paroxetine group （P 〈 0,01）, 30 mg dapoxetine group （P 〈 0,01） and 60 mg dapoxetine group （P 〈 0.01）, respectively, The increase from baseline IELT were similar for the 30 mg dapoxetine and paroxetine groups （P 〉 0,05）, while the 60 mg dapoxetine group had a larger posttreatment IELT increase compared with the 30 mg dapoxetine （P〈 0.05） and paroxetine （P〈 0.01） groups, Dapoxetine （60 mg） 1-3 h before planned intercourse is a very effective treatment modality for PE. However, an on-demand dose of 30 mg dapoxetine is no more effective than the currently prescribed paroxetine treatment.
文摘In this study, a model of migraine was established by electrical stimulation of the superior sagittal sinus in rats. These rats were then treated orally with paroxetine at doses of 2.5, 5, or 10 mg/kg per day for 14 days. Following treatment, mechanical withdrawal thresholds were significantly higher, extracellular concentrations of 5-hydroxytryptamine in the periaqueductal grey matter and nucleus reticularis gigantocellularis were higher, and the expression of phosphorylated p38 in the trigeminal nucleus caudalis was lower. Our experimental findings suggest that paroxetine has analgesic effects in a rat migraine model, which are mediated by inhibition of p38 phosphorylation.
基金supported by the National Science and Technology Support Project No.2006BAI12B05-2the Key Subject Construction Program"211 Project"of Guangdong Province
文摘Depressed patients with scores of 17 or more on the 17 items of the Hamilton Depression Rating Scale were treated with the antidepressant drug paroxetine. They also underwent verum acupuncture or electroacupuncture at Baihui （GV20） and Yintang （GV29）. The World Health Organization Quality of Life Scale Brief Version showed a significant increase in the total scores of patients who underwent verum acupuncture and electroacupuncture for 6 weeks compared with those who were given paroxetine only; significantly increased physical domain and social relationship scores in verum acupuncture patients compared with paroxetine only; and significantly elevated psychological domain scores with electroacupuncture compared with paroxetine only. These results indicate that both verum acupuncture and electroacupuncture can improve quality of life in depressed patients undergoing paroxetine treatment,
文摘Despite progressive improvement in treating major depressive disorder (MDD), it remains mostly unresponsive to one antidepressant medication. Zinc is a brain highly abundant trace metal, a brain derived neurotrophic factor (BDNF) inducer, a modulator of synaptic plasticity and potent suppressor of the NMDA receptors. We proposed that co-administration of zinc with the antide-pressants may represent a valuable regimen to improve the efficacy of these drugs. This work has been implemented to evaluate the behavioral changes of acute and sub-acute co-administration of zinc with Paroxtine in mice. Methods: The animals were injected intra-peritoneal with either Paroxtine (20 mg/kg) which was a selective serotonin reuptake inhibitor (SSRI), zinc sulfate (30 mg/kg) or Paroxtine in combination with zinc for one day and one week (once daily). The pattern of the animal behavior was assessed in the forced swim test (FST). Results and Discussion: The behavioral patterns of the animals in the FST include immobility, swimming and climbing. Successful antidepressant should decrease the immobility time with either increase in swimming and/or climbing behavior based on the drug pharmacological activity. Our results revealed a significant decrease of immobility and increase of swimming behavior indicating serotonin-dependent pharmacological activity of Paroxtine or zinc alone as well as in the animals treated with zinc in combination with Paroxtine. There was no significant difference in the animals’ behavior between acute and sub-acute treatment with zinc or even upon its addition to paroxetine. Our data support the concept that co-administration of zinc may provide further antidepressant activity. Zinc may offer additional clinical value particularly in geriatric patients or other populations where zinc level has shown dramatic decrease.
文摘AIM: To compare the effectiveness and tolerability of paroxetine vs pregabalin for the management of multiple sclerosis(MS)-induced neuropathic pain(NPP).METHODS: A randomized, flexible-dose open-label 8-wk study involving 21 relapsing-remitting MS patients with MS-induced NPP was conducted to evaluate the effectiveness and tolerability of pregabalin versus paroxetine for pain management. The trial included a 3-wk dose titration phase followed by a 5-wk stable dose phase. Primary outcome measures included daily patient-reported pain intensity as measured using a 100 mm visual analogue scale(VAS pain) and daily impact of pain on daily activities(VAS impact). Hierarchical regression modeling was conducted on each outcome to determine if within person VAS trajectory for pain and impact differed across study groups, during 56 d follow-up. RESULTS: Attrition rates were significantly greater(P < 0.001) in the paroxetine versus pregabalin study group(70% vs 18.2%, respectively). Average study duration between study groups also significantly differed(P < 0.001). Paroxetine participants completed an average of 27.3 d of treatment vs 49.5 d in the pregabalin group, with the majority of patients withdrawing due to adverse events. Due to the high attrition rates in the paroxetine study arm, the investigators stopped the study prior to achieving complete recruitment. As such, no significant differences between pregabalin and paroxetine study arms were noted for the primary outcome measures(VAS pain, VAS impact). Comparative assessment of baseline patient characteristics also revealed no significant differences between the study arms. CONCLUSION: High attrition rates associated with paroxetine use suggest that it be used with caution for MS-induced NPP. Efficacy outcomes could not be assessed due to attrition.
文摘Paroxetine is a selective serotonin reuptake inhibitor(SSRI)used in the treatment of depression and anxiety disorders.In some epidemiological studies,slightly increased risks of major malformations and cardiac malformations have been reported following paroxetine exposure in the first trimester of pregnancy.However,such findings have been inconsistent.There is only one report of any overdose of an SSRI during pregnancy,and that involved escitalopram.The aim of this case report was to describe the impact of a paroxetine overdose in the first trimester of pregnancy on the health of the foetus.A 21-year-old mother of one child who was pregnant with a second child was prescribed 20 mg/day paroxetine hydrochloride for the treatment of anxiety/depression.The patient ingested 15 or 1620-mg tablets of paroxetine hydrochloride(300-320 mg)during the 5th week of pregnancy as a suicide attempt.Within 15 min of ingestion,she was admitted to hospital and treated for intoxication.No evidence of maternal SSRI intoxication was observed after treatment.The patient consulted our teratology information service for further risk assessment regarding possible major congenital malformations following the paroxetine overdose.We were unable to find previous reports of paroxetine overdose during pregnancy in the literature.The timely administration of the overdose treatment and the lack of maternal intoxication symptoms were considered positive for the foetal well-being,and the patient was referred for perinatology and psychiatry follow-ups.A healthy,3500-g male infant was born at 38 weeks’gestation,and his development at the age of 2 years was normal.This is the first reported case of paroxetine overdose during pregnancy.Comprehensive studies are needed to evaluate pregnancy outcomes after SSRI overdose.
文摘To study the effect of paroxetine on depressive symptom accompanying somatic disease and the value of platelet 5-HT concentration in the diagnosis of depression, 30 patients with depressive symptom were treated with paroxetine. All patients were evaluated on Zung and HAMD scale and assayed of platelet 5-HT concentration before and after treatment. It was found that patients had a lower level of platelet 5-HT concentration than healthy people (P<0.01). After six weeks of treatment, depressive and somatic symptoms were both improved (P<0.01) and platelet 5-HT concentration was even lower (P>0.05). It was suggested that paroxetine was a good antidepressant and platelet 5-HT concentration was useful in the screening of depression.
文摘The prevalence of persons with social anxiety disorder (SAD) in Japan remains unknown. This study examined 293 patients with age between 20 and 60 at first visit on the outpatient clinic of psychiatry by the section of social phobia of M.I.N.I. and DSM-IV. After that, 10 patients with both SAD out of 16 patients (trial recruited) completed 12 weeks of treatment with paroxetine. Among 63 patients with 4 points and 40 patients with 3 points on the M.I.N.I., 21 patients (33%) and 16 patients (40%) were diagnosed as SAD on DSM-IV criteria, respectively. Together, 37 patients (12.6%) were diagnosed as SAD out of the 293 outpatients. Among 37 patients with SAD, 23 patients (62%) had comorbid depression. As for 10 patients after treatment with paroxetine, 8 patients improved from the point of recovery of depression (HAM-D scores below 10), whereas only 4 patients improved from the point of recovery of social phobia (L-SAS scores below 30). Three points as well as 4 points on the M.I.N.I. is meaningful for the diagnosis of SAD. For a while, paroxetine exerted less beneficial effects on SAD rather than on depression.
文摘OBJECTIVE: Neurocardiogenic syncope (NCS) is a condition where the patient has a temporary loss of consciousness or feelings of weakness and fatigue. There are triggers such as prolonged sitting or standing, pain, and heavy exercise, but often episodes are random. Treatments are limited and the use of specific serotonin reuptake inhibitors (SSRI) have had mixed results, but a limited number of studies have suggested that paroxetine may be effective in improving the symptoms of NCS. METHODS: This is a single case report of a 20-year old female who was diagnosed with NCS by a tilt test and treated conservatively with increased fluid and salt intake, and counter-pressure maneuvers. She was given one dose of sertraline, but immediately experienced disturbing visual images. She presented at the Depression Center with moderate depressive symptoms and was started on paroxetine and given cognitive/behavioral strategies to manage the NCS. RESULTS: Since the patient had a negative experience with a prior SSRI, she was started on a low dose of paroxetine and omega-3 fatty acids. She also was given a detailed explanation of NCS and a number of cognitive/behavioral strategies such as deep breathing, progressive relaxation, imagery, and sleep. CONCLUSION: After 2-weeks of the multi-faceted treatment approach, she had a significant decrease in her depressive symptoms. After 6-months, the patient had no episodes of syncope and no depressive symptoms. She was able to stand for long periods and exercise without feelings of weakness and fatigue. A multimodal approach may offer the best treatment strategy to achieve full remission in patients with NCS.
文摘The mechanism(s) of analgesic action of paracetamol (acetaminophen;N-acetyl-p-aminophenol) remains controversial. Previous studies on rats suggested that the antinociceptive action of paracetamol might involve the central descending inhibitory pain pathways recruiting both a serotoninergic and an opioidergic system. This study explores this issue in mice using paroxetine, the most potent selective serotonin re-uptake inhibitor, and the nonselective opioid pure antagonist naloxone. Animals were divided into two main groups for two separate experiments, each subdivided into 3 subgroups. In both experiments;the first group served as control, the second group received paracetamol (200 mg/kg, i.p). In one experiment, the third group received paroxetine (20 mg/kg p.o for 7 days) before paracetamol. In the other experiment, animals of the third group were pretreated with naloxone (5 mg/kg, i.p) 30 min before paracetamol. The antinociceptive effect of paracetamol was tested using the hot plate test. Paracetamol displayed a significant antinociceptive activity that was augmented by pretreatment with paroxetine as was shown by maintenance of its effect beyond that shown by paracetamol alone. On the other hand, pretreatment with naloxone abolished paracetamol’s antinociceptive activity in the hot-plate test. These results extended the previous observation in rats that the antinociceptive effect of paracetamol involved activation of a central descending pain inhibitory pathway with serotonin and opioidergic peptides being potential mediators recruited.
文摘Objective: to compare the safety of escitalopram and paroxetine in the treatment of senile depression. Methods: in this study, 82 patients with senile depression from November 2018 to June 2020 were selected for analysis. They were divided into control group and observation group according to the order of admission, and were treated with paroxetine and escitalopram respectively. The curative effect, adverse reactions, symptom improvement and satisfaction of the two groups were compared. Results: the effective rate was 97.56%(40 cases) in the observation group and 95.12%(39 cases) in the control group, with no significant difference between the two groups (P > 0.05). The incidence of adverse reactions in the observation group was 4.88%(2 cases), which was lower than that in the control group (19.51%, 8 cases). There was significant difference between the two groups (P < 0.05). Before the treatment, the HADM scores and SDS scores of each group were counted, and the depressive symptoms were evaluated. After the scores were calculated, there was no difference between the observation group and the control group, P > 0.05. After the second and fourth weeks of treatment, the HADM scores and SDS scores of each group were counted. After evaluating the depressive symptoms, the scores in the observation group were lower than those in the control group (P < 0.05). At the eighth week of treatment, the HADM scores and SDS scores of each group were counted, and the depressive symptoms were evaluated. After the scores were calculated, there was no difference between the observation group and the control group, P > 0.05. After counting the satisfaction data of each group, it reached 92.68% in the observation group, which was higher than 75.61% in the control group, with significant differences between groups (P < 0.05). Conclusion: the treatment outcome of escitalopram and paroxetine in the treatment of senile depression patients is equivalent, and both can achieve ideal curative effect, but the former has fast effect and less adverse reactions, which can improve patient compliance, and is more feasible.
文摘Objective: to explore the clinical efficacy of paroxetine in the treatment of patients with depression and anxiety disorder after ischemic stroke. Methods: 80 patients with depression and anxiety disorder after ischemic stroke were randomly divided into two groups. One group was the control group with routine treatment, and the other group was additionally treated with paroxetine. Each group contained 40 patients, and the treatment conditions of the two groups were observed. Results: compared with the control group, the effective rate of the study group was higher (P < 0.05). Before and after treatment, the emotional state, sleep quality and neurotransmitter level of the study group improved more significantly, P < 0.05. Conclusion: paroxetine is helpful to improve the emotional state and sleep quality of patients with depression and anxiety disorder after ischemic stroke, and it is worth popularizing.
基金supported by the National Natural Science Foundation of China(No.81903622)the Natural Science Foundation of Universities of Anhui Province(No.2023AH053290)+5 种基金the Research Fund of Anhui Institute of Translational Medicine(No.2022zhyx-C30)the Open Fund of Key Laboratory of Anti-inflammatory and Immune Medicine,Ministry of Education,P.R.China(Anhui Medical University)(No.KFJJ-2023-03)the Pharmaceutical Innovation Fund of Anhui Medical University(No.YXCX202205)the Nature Science Foundation of Anhui Province of China(No.1908085QH378)the Postgraduate Innovation Research and Practice Program of Anhui Medical University(No.YJS20230060)the Special Clinical Research Project of Shanghai Municipal Health Commission(No.202140065).
文摘Background:G protein-coupled receptor kinase 2(GRK2)could participate in the regulation of diverse cells via interacting with non-G-protein-coupled receptors.In the present work,we explored how paroxetine,a GRK2 inhibitor,modulates the differentiation and activation of immune cells in rheumatoid arthritis(RA).Methods:The blood samples of healthy individuals and RA patients were collected between July 2021 and March 2022 from the First Affiliated Hospital of Anhui Medical University.C57BL/6 mice were used to induce the collagen-induced arthritis(CIA)model.Flow cytometry analysis was used to characterize the differentiation and function of dendritic cells(DCs)/T cells.Co-immunoprecipitation was used to explore the specific molecular mechanism.Results:In patients with RA,high expression of GRK2 in peripheral blood lymphocytes,accompanied by the increases of phosphatidylinositol 3 kinase(PI3K),protein kinase B(AKT),and mammalian target of rapamycin(mTOR).In animal model,a decrease in regulatory T cells(T regs),an increase in the cluster of differentiation 8 positive(CD8+)T cells,and maturation of DCs were observed.Paroxetine,when used in vitro and in CIA mice,restrained the maturation of DCs and the differentiation of CD8+T cells,and induced the proportion of T regs.Paroxetine inhibited the secretion of pro-inflammatory cytokines,the expression of C-C motif chemokine receptor 7 in DCs and T cells.Simultaneously,paroxetine upregulated the expression of programmed death ligand 1,and anti-inflammatory cytokines.Additionally,paroxetine inhibited the PI3K-AKT-mTOR metabolic pathway in both DCs and T cells.This was associated with a reduction in mitochondrial membrane potential and changes in the utilization of glucose and lipids,particularly in DCs.Paroxetine reversed PI3K-AKT pathway activation induced by 740 Y-P(a PI3K agonist)through inhibiting the interaction between GRK2 and PI3K in DCs and T cells.Conclusion:Paroxetine exerts an immunosuppressive effect by targeting GRK2,which subsequently inhibits the metabolism-related PI3K-AKT-mTOR pathway of DCs and T cells in RA.
基金Supported by Open Project of Jiangsu Province Key Laboratory of Integrated Traditional Chinese and Western Medicine for the Prevention and Treatment of Geriatric Diseases,No.202232.
文摘BACKGROUND Post-stroke depression(PSD)is associated with hypothalamic-pituitary-adrenal(HPA)axis dysfunction and neurotransmitter deficits.Selective serotonin reuptake inhibitors(SSRIs)are commonly used,but their efficacy is limited.This study investigated whether combining SSRIs with traditional Chinese medicine(TCM)Free San could enhance their therapeutic effects.AIM To evaluate the clinical efficacy and safety of combining SSRIs with Free San in treating PSD,and to assess its impact on HPA axis function.METHODS Ninety-two patients with PSD were enrolled and randomly divided into control groups(n=46)and study groups(n=46).The control group received the SSRI paroxetine alone,whereas the study group received paroxetine combined with Free San for 4 weeks.Hamilton Depression Scale and TCM syndrome scores were assessed before and after treatment.Serum serotonin,norepinephrine,cortisol,cor-ticotropin-releasing hormone,and adrenocorticotropic hormone were measured.The treatment responses and adverse reactions were recorded.RESULTS After treatment,the Hamilton Depression Scale and TCM syndrome scores were significantly lower in the study group than in the control group(P<0.05).Serum serotonin and norepinephrine levels were significantly higher in the study group than in the control group,whereas cortisol,corticotropin-releasing hormone,and adrenocorticotropic hormone levels were significantly lower(P<0.05).The total efficacy rates were 84.78%and 65.22%in the study and control groups,respectively(P<0.05).No significant differences in adverse reactions were observed between the two groups(P>0.05).CONCLUSION Combining SSRIs with Free San can enhance therapeutic efficacy,improve depressive symptoms,and regulate HPA axis function in patients with PSD with good safety and clinical application value.
文摘Background The neurogenesis in retina of adult mammals is generally abolished, and this renders the retina lack of regenerative capacity. Despite this, there is a small population of nestin-positive cells in the ciliary epithelium which retains neurogenic potential. The present study aimed at investigating the effect of two drugs, corticosterone and paroxetine, on the cell proliferation of the ciliary body. Methods Adult Sprague-Dawley rats were given vehicle, corticosterone, paroxetine, or both corticosterone and paroxetine treatment for 14 days. Cell proliferation in the ciliary body was quantified using 5-bromo-2-deoxyuridine （BrdU） immunohistochemistry. Co-labelling of BrdU and stem cell marker was used to phenotype the BrdU immunoreactive cells. Results Corticosterone treatment suppressed while paroxetine treatment increased the cell proliferation of the ciliary body. Co-labelling with cell markers revealed that the BrdU positive cells also showed nestin expression but not glial fJbrillary acidic protein （GFAP）. Conclusions The results illustrate that proliferation of retinal progenitor cells situated in ciliary body are subjected to regulation by selective serotonin reuptake Jnhibitors （SSRI） and corticosteroJd, which is similar to our previous findings in neurogenic regions in central nervous system （CNS）. Paroxetine treatment could reverse the suppressive effect of corticosterone on ciliary body cell proliferation. This provides information for future investigation of retinal stem cell biology and potential treatment of retinal degenerative diseases.
文摘Objective： To observe the clinical efficacy and adverse reactions of Paroxetine combined with electro-acupuncture （EA） in treating depression. Methods： Forty-two patients with depression were randomly assigned to the observation group （22 patients） treated with EA combined with Paroxetine, and the control group （20 patients） treated with Paroxetine alone, and the therapeutic course for both groups was 6 weeks. The therapeutic efficacy and adverse reactions were evaluated with scores by Hamilton depression scale （HAMD） and treatment emergent symptoms scale （TESS）, respectively. Results： HAMD scores determined at the end of the 1st, 2nd, 4th, and 6th week of the treatment course were significantly lower in the observation group than those in the control group （P〈0.05）. The significant improvement rate evaluated at the end of the 6-week treatment was remarkably higher in the observation group than that in the control group （72.7% vs 40.0%）. No significant difference of TESS scores was found between the two groups. Conclusion： EA combined with Paroxetine has better clinical efficacy than that of Paroxetine alone, with milder adverse reaction and quicker initiation of effect.
