An overview of studies comparing the efficacy, safety, and tolerability of paroxetine and clomipramine

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In a review of six studies comparing paroxetine and the tricyclic antidepressant clomipramine, four of which included patients aged over 65 years, paroxetine was as effective as clomipramine in reducing depressive symptoms. Paroxetine was safe and significantly better tolerated than clomipramine. The data pooled from four studies in elderly patients showed that paroxetine (n=155) was as effective as clomipramine (n=154) and was better tolerated with significantly fewer anticholinergic, central nervous system, and gastrointestinal side-effects. In a six-week study of patients aged between 19 and 64 years paroxetine was less effective but demonstrated a superior safety and tolerability profile compared with clomipramine. However, a further six-week study of paroxetine (30 mg; n=42) and clomipramine (150 mg; n=43) in patients aged less than 65 years showed paroxetine to be as effective as clomipramine in reducing the symptoms of depression and again showed paroxetine's superior safety and tolerability profiles compared with clomipramine.