Efficacy of Paroxetine for the Treatment of Depression in the Context of HIV Infection

Abstract

Recent studies in the literature point out that HIV-infected subjects are affected by depression with a relatively high frequency. The aim of this study was to assess the efficacy and tolerability of paroxetine for the treatment of depression in the context of HIV infection. 15 HIV-infected subjects (10 patients with a major depressive episode and 5 patients with an adjustment disorder with depressed mood, according to the DSM IV diagnostic criteria) were administered paroxetine at a daily dosage of 20 mg. Depressive symptomatology was monitored by means of the Hamilton Rating Scale for Depression (HAM-D) at the time of enrollment and 2 weeks, 4 weeks, and 6 weeks later; at the same times adverse effects were recorded. 14 patients completed the study, and all of these recovered from depression; HAM-D mean scores significantly improved from baseline to final assessment, both when all subjects were considered (ANOVA for repeated measurements: p < or = 0.0001) and when only patients with a major depressive episode were included in the statistical analysis (ANOVA for repeated measurements: p < 0.0001). No significant adverse effects were recorded. Because of its efficacy and good tolerability paroxetine seems to be suitable for the treatment of depression in the context of HIV infection.

Medical Co-Morbidity in Depressive Disorders

“…This study was not powered to determine differences in efficacy. Another small study examining the effectiveness of paroxetine in HIV-positive individuals with depression showed significant improvements in HAM-D scores between weeks 2 and 6 (182). Overall, these studies demonstrate the effectiveness of SSRIs in reducing depressive symptoms in HIV-seropositive individuals and indicate that they may be better tolerated than TCAs, supporting their use as first line agents for the treatment of depression in HIV-seropositive individuals.…”

“…Numerous well designed studies have supported the effectiveness of TCAs (53,129,152,155,(179)(180)(181)(182)(183), for treating depression in HIV infected adults. Head to head studies comparing TCAs and SSRIs have shown equal efficacy for both, but a less favorable side effect profile for TCAs.…”

Depression and HIV/AIDS

“…Several open-label studies have shown support for the efficacy of paroxetine [32,33] and sertraline [34]. In one of the few studies comparing the efficacies of SSRIs in HIV-positive individuals, Ferrando and colleagues [33] compared paroxetine, sertraline, and fluoxetine in 33 symptomatic HIV-positive patients.…”

Depression in Hiv-Infected Men

“…Psychostimulants have improved mood, cognition, and energy levels (Penzak et al, 2000). Fluoxetine (Cazzullo, Bessone, Bertrando, Pedrazzoli, & Cusini, 1998), bupropion (Currier, Molina, & Kato, 2003), methylphenidate and desipramine (Fernandez et al, 1995), paroxetine (Grassi, Gambini, Garghentini, Lazzarin, & Scarone, 1997), and dextroamphetamine (Wagner & Rabkin, 2000) are effective in treating depression in HIV-infected patients. Testosterone may be a useful option in treating HIV-infected men experiencing fatigue and depression (Rabkin, Wagner, McElhiney, Rabkin, & Lin, 2004).…”