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Updated 11 February 2013

Paroxetine

Paroxetine is an antidepressant drug prescribed for the treatment of depression and associated anxiety/panic disorders.

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Paroxetine is the active ingredient of Adco-Paroxetine, Aropax, Austell-Paroxetine, Deparoc, Parax 20, Paxil, Sandoz Paroxetine, Sedarin, Serrapress and XET.

General information

Paroxetine is an antidepressant drug prescribed for the treatment of depression and associated anxiety/panic disorders. It is of particular use for patients struggling with ongoing feelings of sadness, despair, worthlessness, hopelessness, fatigue, pessimism and difficulty dealing with normal daily life.

Paroxetine, and products related to it, is as effective as other, older groups of antidepressants, but has the advantage of fewer side effects and drug interactions. It also does not lead to the same extent of weight gain that is seen when these older antidepressants are used.

It may take several weeks for the full benefit to be achieved. During this period it is important to continue taking this medication.

Paroxetine is also used for obsessive-compulsive disorder and social phobia, which is an intense anxiety of being judged by others, and/or behaving in a way that could lead to embarrassment or ridicule .

This drug has been in the news recently, and featured in a Carte Blanche programme due to the controversial link with suicide. In various countries, this has resulted in legal proceedings against the manufacturer.

How does paroxetine work?

Paroxetine is a selective serotonin re-uptake inhibitor (SSRI), meaning that it increases the levels of the neurotransmitter serotonin in the brain. Increased levels of serotonin are associated with an improvement in emotion, mood and mental state.

Fast facts

Drug schedule: Schedule 5

Available as: Tablets and controlled-release tablets

What does it do? Paroxetine has an antidepressant and mood-elevating action

Overdose risk: Medium

Dependence risk: Low

Available as a generic? Yes

Available on prescription only? Yes

User information

Onset of effect: Full benefit should be seen within 14 - 28 days.

Stopping this medicine: Sudden discontinuation may cause symptoms to recur. The dosage should be gradually reduced according to the advice of your doctor.

Prolonged use: Few, if the medication is used as recommended. Paroxetine is generally only used for 6-12 months at a time.

Special precautions

Paroxetine should not be taken after 4pm to prevent insomnia, unless the drug causes drowsiness, in which case it should be taken just before bedtime.

Alert your doctor before using this drug if:

  • you have liver or kidney disease,
  • you have epilepsy,
  • you have a heart condition, or
  • You are taking or have taken other medication in the last 14 days.

Pregnancy: Avoid. It is unknown how this medication may affect your baby. Consult your doctor before using this drug, or if you are planning to fall pregnant.

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: Safety and efficacy of this medication has not been established for children under the age of 18.

Elderly: Caution is advised in the elderly as adverse effects may be more likely. A reduced dose is advised.

Driving and hazardous work: Caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how it affects you.

Alcohol: Avoid concomitant use of alcohol.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Sexual dysfunction

x

x

Sweating

x

x

Nausea/vomiting

x

x

Diarrhoea/ constipation

x

x

Change in appetite

x

Weight loss/ weight gain

x

x

Anxiety/ insomnia

x

x

Headache

x

x

Dizziness/ drowsiness

x

x

Skin rash

x

x

Convulsions

x

x

Chest pain/ irregular or rapid heartbeat

x

x

Interactions

Drug interactions

Beta blockers

Increased chance of beta blocker toxicity

Verapamil, nifedipine

Increased side effects of vasodilators

Potential sedative substances like alcohol, antihistamines, benzodiazepines

Enhanced effect on central nervous system

Oral medication for diabetes

Blood sugar may drop soon after taking SSRI

Lithium

Potential risk of lithium toxicity

Monoamine oxidase inhibitor

High blood pressure, convulsions. Allow 5 weeks between drugs.

Metoclopramide

Unusual movement disorders

Moclobemide

Increased risk of serotonin toxicity

Buspirone, clomipramine, other SSRIs, pethidine, tricyclic antidepressants

Increased risk of serotonin toxicity

Warfarin

Potential warfarin toxicity

Sumatriptane

Increased risk of CNS toxicity

Terfenadine

Potential terfenadine toxicity

Disease interactions

Consult your doctor before using this drug if you have liver or kidney disease, epilepsy, or if you have a heart condition.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention. Symptoms may include dizziness, sweating, a rapid heartbeat or coma.

Recommended dosage

Adults: 20-40mg daily

Interesting fact

Some sources state that there is evidence that paroxetine may be effective in the treatment of compulsive gambling.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 
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