{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:15:48Z","timestamp":1791357348876,"version":"4.3.1"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,4,21]],"date-time":"2015-04-21T00:00:00Z","timestamp":1429574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100014383","name":"italfarmaco","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100014383","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Human Psychopharmacology"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Paroxetine titration may be difficult in older individuals as they are more sensitive to side effects. The current study extends to 6\u2009months our previously published report in which paroxetine was started at 2.5\u2009mg\/day and slowly increased by 2.5\u2009mg on alternate days (slow titration) or rapidly titrated to target dose from 10\u2009mg\/day (standard titration) in a naturalistic setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Here, the follow\u2010up period was extended to 26\u2009weeks. We performed an intent\u2010to\u2010treat analysis of 47 subjects from the original sample (major depressive disorder and\/or generalized anxiety disorder (GAD); &gt;60\u2009years of age). Missing evaluations were replaced by last observations carried forward. GAD was included as a stratification factor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients in whom paroxetine was slowly up\u2010titrated were more likely to remit (84.0% vs 54.5%; <jats:italic>p<\/jats:italic>\u2009=\u20090.028) and had lower core depression (<jats:italic>p<\/jats:italic>\u2009=\u20090.0015) and psychic anxiety levels (<jats:italic>p<\/jats:italic>\u2009=\u20090.006) after 26\u2009weeks. Dropout rate was 20% in the slow titration group compared with 77.3% in the standard titration arm (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Patients with GAD accounted for all significant associations. No substantial differences were reported between slow and standard titration groups in the subsample without GAD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite some limitations, these findings suggest that paroxetine treatment should be started at lower doses in older depressed patients and slowly up\u2010titrated. This strategy would allow to increase antidepressant response and the likelihood of completing treatment cycle in patients with high anxiety levels and GAD comorbidity. Copyright \u00a9 2015 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hup.2478","type":"journal-article","created":{"date-parts":[[2015,4,22]],"date-time":"2015-04-22T04:52:13Z","timestamp":1429678333000},"page":"329-333","source":"Crossref","is-referenced-by-count":2,"title":["Persistent benefits of slow titration of paroxetine in a six\u2010month follow\u2010up"],"prefix":"10.1002","volume":"30","author":[{"given":"Paolo","family":"Olgiati","sequence":"first","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Serretti","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,4,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-011-1118-8"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1819.2010.02136.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002512-200825060-00004"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e3182905967"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.jcp.0000161498.81137.12"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.3928\/00989134-20111213-01","article-title":"Crushing or splitting medications: unrecognized hazards","volume":"38","author":"Gill D","year":"2012","journal-title":"J Gerontol Nurs"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.13m08442"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1989.tb07177.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr\u201003\u20102012\u20106033"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.5414\/CP201798"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hup.2433"},{"key":"e_1_2_7_13_1","first-page":"35","article-title":"Drug\u2010placebo difference: in antidepressant drug trials could be 50% greater than previously believed","volume":"9","author":"Rihmer Z","year":"2007","journal-title":"Neuropsychopharmacol Hung"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1992.24"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2007.04.034"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1402180"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp073754"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1043-6618(03)00098-7"}],"container-title":["Human Psychopharmacology: Clinical and Experimental"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhup.2478","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hup.2478","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T05:05:39Z","timestamp":1696395939000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hup.2478"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4,21]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2015,9]]}},"alternative-id":["10.1002\/hup.2478"],"URL":"https:\/\/doi.org\/10.1002\/hup.2478","archive":["Portico"],"relation":{},"ISSN":["0885-6222","1099-1077"],"issn-type":[{"value":"0885-6222","type":"print"},{"value":"1099-1077","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,4,21]]}}}