Paxil

Paxil is useful for many mood problems including: depression, obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder, generalized anxiety disorder, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder. Paxil® is a trade name for paroxetine or paroxetine hydrochloride, a selective serotonin reuptake inhibitor (SSRI) antidepressant.

Important Information on Paroxetine

  • Indications: depression, anxiety disorders and other psychiatric disorders
  • Side Effects: nausea, drowsiness, dizziness, blurred vision, headache, changes in sexual behavior, changes in weight, suicidal thinking or behavior
  • Warnings: Paroxetine may increase the risk of suicidal thinking and behavior in children and adolescents. The need for the medication should be carefully weighed against potential risks in this population before initiation of therapy. Children and adolescents on paroxetine should be carefully monitored by the prescriber

 
Uses for this Medicine
It was released in 1992 by the pharmaceutical company GlaxoSmithKline and has since become one of the most prescribed antidepressants on the market.  This is due to its apparent efficacy in treating depression, as well as a spectrum of anxiety disorders ranging from panic attacks to phobias. Paroxetine is primarily used to treat the symptoms of depression, obsessive-compulsive disorder (OCD), panic disorder, generalized anxiety disorder (GAD), social phobia/social anxiety disorder, and premenstrual dysphoric disorder (PMDD).

When this Medicine Should Not be Used
Paroxetine should not be used at the same time as another class of medications called monoamine oxidase inhibitors (MAOI), pimozide, or thioridazine. Patients who are allergic to paroxetine or any of its ingredients should not use it.
 
Dosing
Paxil: Usual adult dosing is 20 to 40 mg daily. Paxil CR: 12.5 to 75mg once daily.
Higher end of dosing range usually required for panic disorder.

Overdosing
Patients who overdose on paroxetine may experience somnolence (excessive sleepiness), coma, nausea, tremor, fast heart rate, confusion, vomiting, dizziness, dilated pupils, excessive sweating, and other symptoms. If this occurs, a healthcare provider should be contacted immediately. Patients who overdose on paroxetine may need to have their stomach emptied by lavage or use of activated charcoal. Treatment is mostly symptomatic and supportive.

Side Effects
General side effects are mostly present during the first 1-4 weeks while the body adapts to the drug. Almost all SSRIs are known to cause either one or more of these symptoms. A person receiving paroxetine treatment may experience a few, all, or none of the following side effects, and most side effects will disappear or lessen with continued treatment, though some may last throughout the duration.

  • nausea
  • teratogenicity: Pregnant women are advised not to take the drug due to possible fetal heart defects.
  • drowsiness
  • headache
  • changes in weight and appetite
  • changes in sexual behavior
  • increased feelings of depression and anxiety (initially)
  • dry mouth
  • rash
  • restlessness or akathisia
  • sodium depletion
  • sweating
  • serotonin syndrome

Individuals experiencing any of the following symptoms should contact their doctor immediately:

  • jaw, neck, and back muscle spasms
  • fever, chills, sore throat, or flu-like symptoms
  • yellowing of the skin or eyes
  • black, tarry stools
  • suicidal thinking or behavior
  • seizure

Paroxetine and other SSRIs have been shown to cause sexual side effects in most patients, both males and females. Although usually reversible, these sexual side effects can sometimes last for months, years or possibly indefinitely even after the drug has been completely withdrawn. This disorder is known as Post SSRI Sexual Dysfunction.
This is not a complete list of all side effects that may occur. Contact your doctor if you notice any other problems while taking this medication.

Drug Interactions
Paroxetine may interact with a group of drugs called monoamine oxidase inhibitors (MAOIs). Patients taking both drugs have had serious and occasionally fatal reactions. Patients should not take paroxetine with MAOIs and should allow 14 days if switching from an MAOI to paroxetine or vice versa. Examples of MAOIs include phenelzine and isocarboxazid.
Paroxetine may also interact with a group of medications called triptans (sumatriptan, zolmitriptan, etc). Patients taking paroxetine with these medications have experienced weakness, incoordination, and hyperreflexia. These effects are part of what is known as the serotonin syndrome. If using both medications, a patient should be under close observation of a physician. Other medications that may cause the serotonin syndrome when used with paroxetine include: linezolid, lithium, tramadol, or St. John’s Wort.
It is recommended that paroxetine not be used in combination with thioridazine or pimizide because this may cause irregular heartbeat, or other heart problems.
This may not be a complete list of all interactions that may occur. Talk to your doctor or pharmacist about any other medications you may take.

How this Medication Works
Paroxetine is a potent selective serotonin (5-hydroxytryptamine, 5-HT) reuptake inhibitor (SSRI). Paroxetine helps to elevate moods and relieve depression by restoring the balance of certain chemicals in the brain.

Discussion Points for You and Your Healthcare Provider

  • Although you may begin notice improvements in your mood within one to two weeks of starting paroxetine, it may take up to four to six weeks for the full effects of the medication to be evident.
  • Patients who are breastfeeding, pregnant, or plan to become pregnant should talk to their healthcare provider.
  • Abrupt withdrawal or discontinuation of this medication may cause withdrawal symptoms. These include dizziness, chills, cold sweats, abdominal pain, weight gain, and parasthesias.
  • Patients who wish to stop taking paroxetine should do so gradually and under the care of a physician.
  • Patients who experience worsening depression or suicidal thoughts should contact their provider immediately.
  • Notify your doctor if you have any allergies to medicines, foods, or other substances.
  • Let your doctor know if you have liver or kidney disease, seizures, or a history of mania, G.I. bleeding or narrow-angle glaucoma.

This information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects. Talk to your doctor, pharmacist or other healthcare provider for more information.

More Information on this Medication