Home > Clinical question: In people with anxiety and comorbid alcohol use disorders, what are the benefits and harms of paroxetine?

There is insufficient randomized controlled trial evidence to support or refute paroxetine treatment in people with anxiety and comorbid alcohol use disorders. Available evidence were deemed of very low quality due to the small study sizes, imprecise measures of effectiveness, and concern that there was bias due to selective reporting.

Two small randomized controlled trials with a total of 57 adults (mean ages 29‐36 years) examined the benefits and harms of paroxetine vs. placebo treatment in patients with anxiety and comorbid alcohol dependence or abuse. Patients given paroxetine were more than twice as likely to respond compared with those given placebo (57.5% vs. 25.8%).

The same trials found no clear benefit or harm from paroxetine in terms of symptom severity, treatment withdrawal due to adverse events, days abstinent, and drinks per day; however they were underpowered to detect a meaningful clinical difference.