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Controlled clinical comparison of paroxetine and fluvoxamine considering the serotonin transporter promoter polymorphism

Kato, Masakia; Ikenaga, Yukab; Wakeno, Masatakaa; Okugawa, Gakua; Nobuhara, Kenjia; Fukuda, Tsuyoshib; Fukuda, Kazuhirob; Azuma, Junichib; Kinoshita, Toshihikoa

International Clinical Psychopharmacology: May 2005 - Volume 20 - Issue 3 - p 151-156
Original Articles

The present study aimed to compare the effects of two currently used selective serotonin reuptake inhibitors (SSRIs) in Japan taking the individual background in 5-HTT gene-linked polymorphic region (5HTTLPR) genotype into account. Clinical responses to paroxetine and fluvoxamine were evaluated by total and cluster depressive symptoms for 81 Japanese patients who were diagnosed with major depression. Patients with the l allele had a greater percentage reduction on the total score (P=0.059) and somatic anxiety items (P=0.026) of the 21-item Hamilton Depression Rating Scale (HAM-D) score compared to s/s genotype carriers. Paroxetine was significantly more effective than fluvoxamine in the s/s carriers, as evaluated on the percentage reduction in total score (P=0.012) and core (P=0.049) HAM-D after 4 weeks of medication, but not in the l/s carriers. These findings suggest that the genetic test may be useful in investigating the efficacy of the two SSRIs, and that normalization by the 5HTTLPR genotypes may lead to improvement of the precision of comparative analysis.

aDepartment of Neuropsychiatry, Kansai Medical University

bClinical Evaluation of Medicines and Therapeutics, Graduate School of Pharmaceutical Sciences, Osaka University, Japan

Correspondence and requests for reprints to Dr Masaki Kato, Department of Neuropsychiatry, Kansai Medical University, 10–15 Fumizonocho Moriguchi, Osaka 570–8506, Japan

Tel: +81 6 6992 1001; fax: +81 6 6995 2669;


Received 30 November 2004 Accepted 24 January 2005

© 2005 Lippincott Williams & Wilkins, Inc.