Paroxetine (Oral)

As a selective serotonin reuptake inhibitor, Paroxetine works by increasing activity levels inside a patient's brain, making it useful in treating a range of conditions.

Overview

Paroxetine is a medicine given to patients who are suffering from social anxiety disorder (also known as social phobia), post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, premenstrual dysphoric disorder (PMDD), or depression. Also, the drug Brisdelleâ„¢ is used to treat patients with moderate to severe hot flashes that are caused by menopause.

Paroxetine is a part of a group of medicines that are called selective serotonin reuptake inhibitors, or SSRIs. It is believed that this group of medicines works by increasing the activity of serotonin in the patient's brain. Be aware that you can only obtain Paroxetine with a prescription from your doctor. It is only given to certain patients and has a very specific set of uses.

Condition(s) treated

  • Social anxiety disorder

Type of medicine

  • Selective serotonin reuptake inhibitor

Side Effects

As well as having its intended effects, it is possible that Paroxetine will cause patients to experience a range of other side effects. These side effects can range in their severity and their need for attention. Directly below is a list of the more severe side effects that may occur. If you experience any of these whilst taking Paroxetine, you should contact your doctor immediately

Less common

  • Lightheadedness, dizziness, or faintness when getting up from a sitting or lying position

Rare

  • Increased sensitivity of your eyes to light

Incidence not known

As well as these more serious side effects, you could experience others which are less worrying and don't necessarily require medical attention. Below is a list of these less serious effects. You may find that, as your treatment progresses and your body adjusts to the medicine, the side effects will wear off. However, if they are bothersome or lingering, then you can still contact your doctor. They may be able to advise on ways to reduce the unwanted effects, such as by altering your doses of Paroxetine.

More common

  • Stuffy or a runny nose

Less common

  • Lump in the throat

Though these lists are extensive, they are not necessarily all-inclusive. This means you may experience other side effects not listed here. If this is the case and you would like to discuss them at all, then you should contact your doctor.

Dosage

Below you can find the typical doses of Paroxetine that are prescribed to patients suffering from a range of different conditions. Be aware that the doses listed below may be different to what you have been prescribed. This is because each patient is unique in their needs, and the doses are based on the extent of your condition as well as a number of other factors. You should not alter how much of or how frequently you take Paroxetine unless your doctor tells you to do so.

When taking capsules to treat moderate to severe hot flashes that have been caused by menopause:

  • Adults. Take 7.5mg once per day just before bed.

When using suspension to treat depression:

  • Adults. To start, take 20mg once per day, usually in the morning. Your doctor may then alter your dose if needed. Although, the total daily dose is not usually more than 50mg.

When using suspension to treat generalized anxiety disorder:

  • Adults. To start, take 20mg once per day, usually in the morning. Your doctor may then alter your dose if needed. Although, the total daily dose is not usually more than 50mg.

When using suspension to treat obsessive-compulsive disorder:

  • Adults. To start, take 20mg once per day, usually in the morning. Your doctor may then alter your dose if needed. Although, the total daily dose is not usually more than 60mg.

When using suspension to treat panic disorder

  • Adults. To start, take 10mg once per day, usually in the morning. Your doctor may then alter your dose if needed. Although, the total daily dose is not usually more than 60mg.

When using suspension to treat post-traumatic stress disorder:

  • Adults. To start, take 20mg once per day, usually in the morning. Your doctor may then alter your dose if needed. Although, the total daily dose is not usually more than 50mg.

When using suspension to treat social anxiety disorder:

  • Adults. To start, take 20mg once per day, usually in the morning.

When using tablets to treat depression:

  • Adults. To start, take 20mg once per day, usually in the morning. Your doctor may then alter your dose if needed. Although, the total daily dose is not usually more than 50mg.

When using tablets to treat generalized anxiety disorder:

  • Adults. To start, take 20mg once per day, usually in the morning. Your doctor may then alter your dose if needed. Although, the total daily dose is not usually more than 50mg.

When using tablets to treat obsessive-compulsive disorder:

  • Adults. To start, take 20mg once per day, usually in the morning. Your doctor may then alter your dose if needed. Although, the total daily dose is not usually more than 60mg.

When using tablets to panic disorder:

  • Adults. To start, take 10mg once per day, usually in the morning. Your doctor may then alter your dose if needed. Although, the total daily dose is not usually more than 60mg.

When using tablets to treat post traumatic stress disorder:

  • Adults. To start, take 20mg once per day, usually in the morning. Your doctor may then alter your dose if needed. Although, the total daily dose is not usually more than 50mg.

When using tablets to treat social anxiety disorder:

  • Adults. To start, take 20mg once per day, usually in the morning.

When using extended-release tablets to treat depression:

  • Adults. To start, take 25mg once per day, usually in the morning. Your doctor may then alter your dose if needed. Although, the total daily dose is not usually more than 62.5mg.

When using extended-release tablets to treat panic disorder:

  • Adults. To start, take 12.5mg once per day, usually in the morning. Your doctor may then alter your dose if needed. Although, the total daily dose is not usually more than 75mg.

When using extended-release tablets to treat premenstrual dysphoric disorder:

  • Adults. To start, take 12.5mg once per day, usually in the morning. Your doctor may then alter your dose if needed. Although, the total daily dose is not usually more than 25mg.

When using extended-release tablets to treat social anxiety disorder:

  • Adults. To start, take 12.5mg once per day, usually in the morning. Your doctor may then alter your dose if needed. Although, the total daily dose is not usually more than 37.5mg.

You should aim to never miss a scheduled dose, as this will limit the effectiveness of your treatment. If you do miss a dose for any reason, you should take it as soon as you remember. However, if it is almost time for your next dose, skip the missed one and resume your regular schedule. It is important you do not double dose.

You should follow your doctor's prescription as closely as possible, and never take this drug any more frequently or do not take any more of it.

You will find a Medication Guide with this medicine. You should read it thoroughly and address any questions to your doctor.

You can take Paroxetine either with or without food.

You may find that you need to take this drug for at least a month before you start to feel better.

If you are taking the oral suspension form of this medicine, you should first shake the bottle well before measuring your dose. Avoid using tablespoons and teaspoons for measuring, as these are not always accurate. Instead, use a measuring spoon or small measuring cup.

If you are taking the tablet or extended-release tablet, then you should swallow it whole. Do not chew, break, or crush it.

There are different brands of Paroxetine available. Each one has different uses. You should stick to only using the brand prescribed to you by your doctor.

Interactions

It is possible that Paroxetine will interact with other medicines you are currently taking. You should, therefore, inform your doctor of any drugs you use, both prescription and nonprescription. In many cases, it is best to avoid interactions. However, under other circumstances, it may be best to allow an interaction to occur. Either way, your doctor can decide if any medicines you take should be changed, or whether any doses should be altered to limit interactions. Directly below is a list of medicines with which it is not recommended you take at the same time as Paroxetine. Your doctor may, therefore, need to change one or both of these medicines.

  • Mesoridazine

It is usually not recommended that you take Paroxetine at the same time as any of the following medicines. However, it may be best for your treatment that you take both. If this is the case, your doctor may alter one or both doses you receive.

  • Nadroparin

If you take Paroxetine at the same time as any of the following medicines, then you may be at a greater risk of experiencing certain side effects. However, it may still be best for your treatment to receive both medicines. If this is the case, your doctor may need to alter one or both doses of the interacting medicines.

  • Fluphenazine

As well as drugs, it is possible that Paroxetine will interact with certain aspects of your dietary intake. This includes what you eat, smoke, and drink. As such, your doctor may advise that you make changes to your lifestyle or diet in order to avoid these unwanted interactions. For example, they may require you to smoke less tobacco or drink less alcohol.

Finally, it is also possible that an interaction will occur between Paroxetine and other medical problems you have. You should inform your doctor of your complete medical history, and be extra aware of the following which are known to interact more severely with Paroxetine.

Warnings

Before you are prescribed this medicine, your doctor will first want to examine you to ensure it is safe and best suited to your condition. As a part of this, they will need to be aware of any allergies you have. This includes allergies to dyes, animals, preservatives, or foods.

As of writing, efficacy and safety have not been established for the use of Paroxetine in younger patients. This is because no suitable studies have been performed on the use of this drug on pediatric patients. Your doctor is best placed to advise on any increased risks to your child and to decide whether this is a suitable drug to take. However, be aware that using Brisdelleâ„¢ is not indicated in younger patients.

The appropriate studies that have taken place in older patients have not highlighted any geriatric-specific problems that would make this drug less useful in geriatric patients. However, you should be aware that older patients tend to be more susceptible to the effects this medicine can have, as compared to younger adults. Older patients are more likely to have low sodium in their blood (hyponatremia), which would mean their doses of this medicine would need to be adjusted.

As of writing, there are also no suitable studies into the use of Paroxetine in patients who are breastfeeding. Your doctor is best placed to advise on any increased risks to you or your infant, and to then weigh these against the benefits.

Your doctor will want to set regular appointments to track your condition over time. It is important you attend these as it gives the doctor chance to check for any unwanted effects you may be experiencing and to adjust your prescription accordingly.

If you take this medicine whilst pregnant, then you could harm your unborn child. It is advised that you use effective birth control whilst taking this medicine. If you do become pregnant whilst taking Paroxetine, you should inform your doctor immediately.

You should not take Paroxetine at the same time as an MAO inhibitor, or the 2 weeks after you stop taking one. Similarly, you should wait for two weeks after taking Paroxetine before you start taking an MAO inhibitor. Failure to take this precaution could lead to extremely high blood pressure, severe convulsions, confusion, agitation, a sudden high body temperature, stomach or intestinal symptoms, or restlessness. Here are examples of MAO inhibitors:

  • Selegiline [Eldepryl]

Do not take thioridazine (Mellaril) or pimozide (Orap) at the same time as Paroxetine. Doing so can lead to very serious heart problems.

If you take Paroxetine at the same time as the following medicines, then you could develop a serious condition known as serotonin syndrome. In fact, before taking any other medicines at the same time as Paroxetine, you should first check with your doctor.

  • Tryptophan

Paroxetine can potentially decrease the amount of sperm you make, or the ability of a man to have children. If you are planning to have children, then you should discuss this with your doctor before taking this medicine.

Taking Paroxetine can cause some young adults and teenagers to become irritable, agitated, or to experience other abnormal behaviors. It can also cause others to become depressed or have suicidal thoughts or tendencies. It could also lead to a big increase in energy, difficulty sleeping, reckless behavior, or getting up easily. You should inform a doctor right away if you or your child starts to display these symptoms. If anyone in your family, or yourself, has ever tried to commit suicide or has bipolar disorder (manic-depressive), you should inform your doctor.

You should first check with your doctor before you stop taking this medicine. They may well want to gradually decrease your doses rather than stopping suddenly. This decreases your chance of experiencing the withdrawal symptoms listed below.

  • Breathing problems

If you display any of the following symptoms within the first few weeks of taking Paroxetine, you should inform your doctor right away.

  • A need to keep moving

It is not recommended that you consume alcohol whilst taking Paroxetine.

This drug may cause some patients to have blurred vision or to become drowsy. As such, you should not drive or perform any other dangerous tasks until you know how this medicine affects you.

When taking this medicine, you may experience hyponatremia (low sodium in your blood). If you display any of the following symptoms, inform your doctor.

  • Unsteadiness

Paroxetine could increase your chances of having bleeding problems. If you are taking any other medicines which thin your blood, you should tell your doctor. This includes the following:

  • Warfarin (Jantoven, Coumadin)

Taking Paroxetine could increase your chances of getting fractured bones. If you suffer any unexplained bone bruising, tenderness, swelling, or pain, you should tell your doctor immediately. You can also ask your doctor for advice on how to prevent fractures by keeping your bones strong.

You should not take any other medicines at the same time as this medicine unless you have been told to do so by your doctor. This includes both prescription and nonprescription drugs.

Storage

You should store your Paroxetine in a sealed container, and keep it at room temperature, safely away from children. It should not be allowed to freeze, and should not be exposed to direct light, moisture, or heat. Once you have finished your treatment, you should dispose of any remaining medicine in a safe and sensible manner as advised by your doctor. The same applies to any medicine that goes out of date.

Summary

If you are suffering from a range of mental conditions, then Paroxetine can be a very useful medicine in helping to reduce your suffering and make your conditions more manageable. However, you should be aware that this drug is strictly suitable for only certain patients. It is known to interact with a range of other drugs and can cause a variety of side effects. In order to prevent these unwanted effects and interactions, your doctor will be able to advise you on the best way to take this medicine and how much of it.

Above you can find full details regarding the side effects you may experience while taking this medicine. If you are worried by your side effects at any time, you can contact your doctor. You should follow any guidance they give you regarding this medicine. Be aware that, in the best interests of managing your condition, they may also recommend you make certain lifestyle changes as well. If you have any questions at all about your treatment you should discuss them with your doctor.