A randomized placebo-controlled trial of paroxetine for the management of anxiety in chronic obstructive pulmonary disease (PAC study)

Zafar A. Usmani, Kristin V. Carson-Chahhoud, Adrian J. Esterman, Brian J. Smith

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Background: Despite the high prevalence of anxiety in COPD patients and its impact on quality of life, evidence to support the effectiveness of various anxiety treatment options is insufficient, leading to the need for further research in this field. Aim: The aim of this study was to assess the efficacy and safety of paroxetine for the management of anxiety in COPD and the impact of treatment on patients’ quality of life and rate of hospitalization. Patients and methods: In a double-blind, randomized, controlled trial, COPD patients were allocated into groups that either received paroxetine 20 mg or placebo pills daily, for four months. Differences in outcomes were assessed based on an intention-to-treat analysis using linear mixed effects models. A chi-square test was used to compare the number of COPD-related admissions. Results: Thirty-eight participants were recruited. Twenty-two of these completed the trial. A clinically and statistically significant reduction was noted in anxiety symptoms after four months of treatment compared to the placebo. Clinically important improvement was noted in depression symptoms, with no statistically significant differences in walking distance or quality-of-life measure outcomes. The intervention group had less COPD-related admissions compared to the placebo group but experienced medication-related side effects. Conclusion: Treatment with paroxetine significantly improved anxiety levels, but this difference did not translate into improved quality of life at four months follow-up.

Original languageEnglish
Pages (from-to)287-293
Number of pages7
JournalJournal of Multidisciplinary Healthcare
Publication statusPublished or Issued - 27 Jun 2018
Externally publishedYes


  • Anxiety
  • BAI
  • COPD
  • Emphysema
  • Paroxetine
  • Pharmacotherapy

ASJC Scopus subject areas

  • Nursing(all)

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