Neuropsychiatric Disease and Treatment (Sep 2014)

Factors affecting discontinuation of initial treatment with paroxetine in panic disorder and major depressive disorder

  • Aoki A,
  • Ishiguro S,
  • Watanabe T,
  • Ueda M,
  • Hayashi Y,
  • Akiyama K,
  • Kato K,
  • Inoue Y,
  • Tsuchimine S,
  • Yasui-Furukori N,
  • Shimoda K

Journal volume & issue
Vol. 2014, no. default
pp. 1793 – 1798


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Akiko Aoki,1 Shin Ishiguro,1 Takashi Watanabe,1 Mikito Ueda,1 Yuki Hayashi,1 Kazufumi Akiyama,2 Kazuko Kato,3 Yoshimasa Inoue,1 Shoko Tsuchimine,4 Norio Yasui-Furukori,4 Kazutaka Shimoda11Department of Psychiatry, 2Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Tochigi, Japan; 3Sakura La Mental Clinic, Tochigi, Japan; 4Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Aomori, Japan Objective: The aims of the present study were to analyze the association between discontinuation of paroxetine (PAX) and the genetic variants of the polymorphism in the serotonin ­transporter gene-linked polymorphic region (5-HTTLPR) in Japanese patients with panic disorder (PD) and major depressive disorder (MDD).Methods: The 5-HTTLPR genotype was determined by polymerase chain reaction method. PAX plasma concentration was measured by high-performance liquid chromatography to confirm adherence.Results: When comparing between the PD and MDD patients with the chi-square test and Fisher’s exact test, the PD patients had a significant and higher discontinuation rate due to nonadherence than did the MDD patients (13.5% [7/52] versus 0% [0/88], respectively; P<0.001). MDD patients had a significant and higher discontinuation rate due to untraceability than PD patients (12.5% [11/88] versus 1.9% [1/52]; P=0.032). Multilogistic regression revealed a tendency for the long/short and short/short genotypes to affect discontinuation due to adverse effects in PD patients (25.0% versus 6.3%, respectively; P=0.054). Conclusion: The results indicate that the 5-HTTLPR genotype might contribute to the discontinuation of initial PAX treatment due to adverse effects in PD patients. Keywords: paroxetine, discontinuation, panic disorder, major depressive disorder