- What is paroxetine, and how does it work (mechanism of action)?
- What brand names are available for paroxetine?
- Is paroxetine available as a generic drug?
- Do I need a prescription for paroxetine?
- What are the side effects of paroxetine?
- What is the dosage for paroxetine?
- Which drugs or supplements interact with paroxetine?
- Is paroxetine safe to take if I'm pregnant or breastfeeding?
- What else should I know about paroxetine?
What is paroxetine, and how does it work (mechanism of action)?
Paroxetine is an oral drug that is used for treating depression. It is in a class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also contains fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft). Paroxetine affects neurotransmitters, the chemicals that nerves within the brain use to communicate with each other. Neurotransmitters are manufactured and released by nerves and then travel and attach to nearby nerves. Thus, neurotransmitters can be thought of as the communication system of the brain. Serotonin is one neurotransmitter that is released by nerves in the brain. The serotonin either travels across the space that lies between nerves and attaches to receptors on the surface of nearby nerves or it attaches to receptors on the surface of the nerve that produced it, to be taken up by the nerve and released again (a process referred to as re-uptake).
Many experts believe that an imbalance among neurotransmitters is the cause of depression. Paroxetine works by preventing the reuptake of one neurotransmitter, serotonin, by nerve cells after it has been released. Since reuptake is an important mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves, the reduced uptake caused by paroxetine increases free serotonin that stimulates nerve cells in the brain. The FDA approved paroxetine in December 1992.
What are the side effects of paroxetine?
Common side effects of paroxetine are:
- dry mouth,
- diarrhea and
- loss of appetite.
Other important side effects include:
Some patients may experience withdrawal reactions upon stopping paroxetine. Symptoms of withdrawal include:
The dose of paroxetine should be gradually reduced when therapy is discontinued.
Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of paroxetine or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.
What is the dosage for paroxetine?
The recommended dose is 20-60 mg daily of immediate release tablets or 12.5-75 mg daily using controlled release tablets. Paroxetine is given as a single daily dose, usually in the morning. As with all anti-depressants, the full effect may not occur until after a few weeks of therapy.
Doses for obsessive-compulsive disorders and panic disorders are often higher than those for depression. Doses often are adjusted to find the optimal dose.
Elderly patients, debilitated persons, and patients with certain kidney or liver diseases may need lower doses because they metabolize and eliminate paroxetine more slowly and, therefore, are prone to develop high blood levels and toxicity.
Which drugs or supplements interact with paroxetine?
All SSRIs, including paroxetine, should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl, Carbex), and procarbazine (Matulane) or other drugs that inhibit monoamine oxidase such as linezolid (Zyvox) and intravenous methylene blue.
Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. (A period of 14 days without treatment should lapse when switching between paroxetine and MAOIs.) Similar reactions occur when paroxetine is combined with other drugs for example, tryptophan, St. John's wort, meperidine (Demerol), tramadol (Ultram) that increase serotonin in the brain.
Paroxetine may increase the effect of the blood thinner, warfarin (Coumadin), leading to excessive bleeding. Therefore, warfarin therapy should be monitored more frequently in patients who are also taking paroxetine. Combining SSRIs such as paroxetine with aspirin, nonsteroidal anti-inflammatory drugs or other drugs that affect bleeding may increase the likelihood of upper gastrointestinal bleeding. Phenytoin (Dilantin) and phenobarbital may decrease the amount of paroxetine in the body and possibly reduce its effectiveness.
Is paroxetine safe to take if I'm pregnant or breastfeeding?
Paroxetine is secreted in breast milk. Mothers who are taking paroxetine should consider not breastfeeding.
What else should I know about paroxetine?
What preparations of paroxetine are available?
Tablets: 10, 20, 30, and 40 mg; Paxil CR Tablets: 12.5, 25, and 37.5 mg; Suspension: 10 mg/5ml
How should I keep paroxetine stored?
Tablets should be kept at room temperature, 59 F - 86 F (15 C - 30 C). The suspension and controlled release tablets should be stored at or below 77 F (25 C).
Quick GuidePhysical Symptoms of Depression in Pictures
Paroxetine Paxil, Paxil CR, Paxeva is a drug used to treat depression, OCD, PTSD, premenstrual dysphoric disorder, and social anxiety disorder. Paroxetine is an SSRI and should not be taken with MAOIs, and some blood thinners. Common side effects include nausea, headache, anxiety, constipation, and more. Side effects, drug interactions, warnings and precautions, and pregnancy safety information should be reviewed prior to taking any medication.
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Treatment & Diagnosis
- Poor Hygiene
- Mood Swings
- Unusual Behavior
- Indigestion (Dyspepsia, Upset Stomach)
- Inability to Regulate Emotions
- PMS (Premenstrual Syndrome)
- Panic Attack
- Doctor: Checklist to Take To Your Doctor's Appointment
- Bipolar Disorder
- Generalized Anxiety Disorder
- Postpartum Depression
- Illness Anxiety Disorder (Hypochondria)
- Posttraumatic Stress Disorder FAQs
- Stress FAQs
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- Medication Disposal
- Dangers of Mixing Medications
- Post-Traumatic Stress Disorder - Treatment
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- Paxil & Pregnancy, Possibilty of Birth Defect
- Obsessive Compulsive Disorder (OCD), More Common Than You Think
- Herbs: Toxicities and Drug Interactions
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
- Sertraline (Zoloft)
- Lexapro (escitalopram)
- Antidepressants (Depression Medications)
- Lexapro vs. Wellbutrin: Differences between Side Effects and Uses
- Anxiolytics (for Anxiety) Drug Class Side Effects
- citalopram, Celexa
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- Drug Interactions
- fluoxetine, Prozac, Sarafem, Prozac Weekly
- Buspar vs. Zoloft (Differences between Side Effects and Uses)
- fluvoxamine (Luvox and Luvox CR have been discontinued)
Prevention & Wellness
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- Study Questions Link Between Antidepressants, Miscarriage
- Antidepressants in Pregnancy Won't Harm Baby's Heart, Study Suggests
- Weight Gain From Antidepressants Is Minimal, Study Suggests
- Antidepressants in Pregnancy Tied to Slight Risk of Lung Disorder in Babies
- Experts Lay Out Options for Menopause Symptoms
- Antidepressant Use During Pregnancy Not Linked to Autism
- Taking Antidepressants During Pregnancy May Not Raise Autism Risk
- First Non-Hormonal Remedy Approved for Menopausal Hot Flashes
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- Internet Search History May Reveal Unknown Drug Side Effects
- Common Antidepressants Too Risky During Pregnancy, Researchers Say
- Some Antidepressants May Raise Stroke Risk
- Antidepressants Aid Depressed Parkinson's Patients
- Antidepressants May Raise Risk for Pregnancy Complication
- Prescription Meds Can Put on Unwanted Pounds
- Newer Antidepressants Work Equally Well, Study Finds
- Treatment Shows Promise for Premature Ejaculation
- Study: Antipsychotic Drug Does Not Help Veterans With PTSD
- Antidepressant Use in Pregnancy: Autism Risk?
- Depression Rising, but Psychotherapy Declines
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- Depression: Major Depression
- Psychotic Depression
- Depression Caused by Chronic Illnesses
- Depression Risk Assessment Tool
- Diagnosing Depression
- Drug Name Confusion: Preventing Medication Errors
- Sleep and Depression
- Paxil CR and Avandamet, FDA Seizes Product
- Kids on Antidepressants Suicide Alert
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