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Aim: The main purpose of this study was to evaluate the efficacy of paroxetine controlled-release (CR) formulation compared to placebo. A secondary objective was to test the hypothesis that the CR decreases selective-serotonin-reuptake-inhibitors-induced nausea as its formulation allows more distal gastrointestinal absorption than the paroxetine immediate-release (IR) formulation. Methods: We conducted this study in Japanese and Korean patients with major depressive disorder (MDD) in order to demonstrate the efficacy and safety of paroxetine CR compared with placebo. The primary efficacy end-point was the adjusted mean change from baseline in the 17-item Hamilton Rating Scale for Depression total score at Week 8. Results: A total of 416 patients with MDD were randomly assigned to the CR, IR and placebo groups. The mean change from baseline in the 17-item Hamilton Rating Scale for Depression was −12.8 in the CR group, −12.5 in the IR group, and −10.4 in the placebo group, which showed a statistically significant difference compared to placebo in CR ( P < 0.001) and IR ( P = 0.015). The incidence of adverse events was 65% in CR, 69% in IR and 55% in placebo. The adverse events were mostly mild or moderate in severity. In the early treatment period, when initiated from 12.5 mg, the incidence of nausea in the CR group was 6%, which was comparable with that of placebo (5%). Conclusion: Paroxetine CR is efficacious in the acute treatment of MDD and may have the potential benefit of decreasing the incidence of nausea in the early treatment period. [ABSTRACT FROM AUTHOR]

Abstract: Background: The gender ratio (male/female) of suicide rates greatly differs by country and by age group. These differences are accompanied by differences in the use of violent methods of suicide. Methods: The gender ratio of suicide rates and the methods used were calculated from the most recently available official electronic mortality data published by the four countries (two Eastern (Korea and Japan) and two Western (Australia and the United states) countries) and from the World Health Organization [WHO] mortality database. Suicide gender ratios based on 95% Confidence intervals (CIs) were used to compare the countries between age groups. Results: The gender ratio of suicide rates was higher in the United States (3.9) and Australia (3.3), where gender differences in suicide methods were more prominent, than in Korea (1.8) and Japan (2.7). In the United States and Australia, the gender ratios greatly increased in the elderly (age 70 years and over), with a higher use of firearms by men. The gender ratio of suicide rates was lowest (1.0) in the young (age 20–29) in Korea, where hanging was a more common method in women than in men. Limitations: The study does not consider the various other factors that may have influenced gender differences of suicide rate. Conclusions: These findings suggest that differences in suicide methods play a role in determining the differences in the gender ratio of suicide rates between countries. Because suicide methods varied with gender, age, and country and may play a role in the suicide rates of each group, these parameters should be taken into account in the design of suicide prevention measures. [Copyright &y& Elsevier]