Paroxetine effective and well-tolerated treatment of erythema of rosacea

Erythema of rosacea is a condition that causes facial redness and small, red, pus-filled bumps. Middle-aged women with fair skin most commonly experience rosacea. It can be confused with acne or other skin conditions.

Paroxetine is a selective serotonin reuptake inhibitor, which is a type of antidepressant (SSRI). It is frequently used to treat depression, obsessive-compulsive disorder (OCD), panic attacks, anxiety, and post-traumatic stress disorder (PTSD).

The prospective Rosacea Refractory erythema trial was a multicenter, randomized, double-blind, placebo-controlled trial involving patients with moderate to severe erythema of rosacea. For a 12-week period, patients were randomly assigned (1:1) to either receive paroxetine or a placebo.

The study results were interpreted using the Clinical Erythema Assessment Score of 0, 1, or a ≥2-grade improvement from baseline at week 12.

The study had the following clinical takeaways:

1. The proportion of patients who passed the Clinical Erythema Assessment at week 12 was significantly higher in the paroxetine group than in the placebo group (42.9% vs. 20.8%).
2. Some secondary endpoints, such as flushing success and improvement in burning sensation and depression, were also met.
3. The study also discovered that paroxetine was well-tolerated, with dizziness, lethargy, nausea, dyspepsia, and muscle tremors being the most commonly reported adverse events.

While the study had some limitations, such as only evaluating a single-dosage regimen of paroxetine within a 12-week study, the findings suggest that paroxetine may be a viable alternative treatment for patients with refractory erythema of rosacea who have limited treatment options.

According to Dr. Ben Wang, the study's lead author, “Further studies are needed to confirm these findings and to determine the optimal dosing and duration of treatment with paroxetine for erythema of rosacea.”

Reference:

Wang B., Huang Y., Tang Y. Zhao Z. Shi W., Jian D., Liu F. Gao Q. Wang P., Yang J., Li L., Xie H., Li J.; Paroxetine is an effective treatment for refractory erythema of rosacea: Primary results from the Prospective Rosacea Refractory Erythema Randomized Clinical Trial; Journal of American Academy of Dermatology; 2023.02.14; DOI: https://doi.org/10.1016/j.jaad.2023.01.044