Paroxetine (Paxil)

• Type of Drug: Selective serotonin re uptake inhibitor (SSRI)-type antidepressant.
• Prescribed for: Depression.

Paroxetine (Paxil) General Information

Paroxetine and the other SSRIs (Fluvoxamine, Fluoxetine, and Sertraline) are chemically unrelated to the older tricyclic and tetracyclic antidepressant medicines. They work by preventing the movement of a neurohormone, serotonin, into nerve endings. This forces the serotonin to remain in the spaces surrounding nerve ending s, where it works. Paroxetine is effective in treating common symptoms of depression. It can help improve your mood and mental alertness, increase physical activity, and improve sleep patterns. Tolerance to the effects of Paroxetine may develop over time. The drug takes between 1 and 4 weeks to start working, though you may experience some improvement in sleep patterns within 1 to 2 weeks. It stays in the body for several weeks, even after you stop taking it. This may be important when your doctor starts or stops treatment.

Unlike other SSRIs, Paroxetine does not have any weight- reducing effect.

Paroxetine (Paxil) Cautions and Warnings

Do not take Paroxetine if you are allergic to it. Allergies to other antidepressants should not prevent you from taking Paroxetine, because the drug is chemically different from other antidepressants.

A 2-week drug-free period should be allowed between Paroxetine and a monoamine oxidase (MAO) inhibitor antidepressant.

Paroxetine is broken down by your liver; therefore, people with severe liver disease should be cautious about taking this drug and should be treated with doses that are lower than normal.

People with reduced kidney function should take this drug with caution.

Studies in animals receiving doses 10 to 20 times the maximum human dose revealed an increase in certain liver tumors and reduced fertility. The importance of this information to humans is not known.

A small number of manic or hypomanic patients may experience ah activation of their condition while taking Paroxetine.

Paroxetine should be given with caution to patients who suffer from seizure disorders.

Paroxetine causes a reduced blood level of uric acid but has not caused kidney failure.

The possibility of suicide exists in severely depressed patients and may be present until the condition is significantly improved. Depressed patients should be allowed to carry only small quantities of Paroxetine with them to prevent overdose.

Paroxetine (Paxil) Possible Side Effects

Paroxetine side effects are generally mild, often related to the size of the dose you are taking, and occur mostly during the first week you take this medicine.

• Most common: headache, weakness, sleep disturbances, dizziness, and tremors.
• Common: nausea, sweating, dry mouth, constipation, decreased sex drive, abnormal ejaculations, blurred vision, and weight gain.
• Less common: flushing, pinpoint pupils, increased saliva, cold and clammy skin dizziness when rising quickly from a sitting or standing position, blood-pressure changes, swelling around the eyes and in the arms or legs, coldness in the hands or feet, fainting and dizziness, rapid heartbeat, weakness, loss of coordination, unusual walk, changes in the general level of activity, migraines, droopy eyelids, acne, hair loss, dry skin, difficulty swallowing, stomach gas, joint pains, muscle pains, cramps and weakness, aggressiveness, abnormal dreaming or thinking, memory loss, apathy, delusions, a feeling of detachment, worsened depression, emotional instability, a “high” feeling, hallucinations, neurosis, paranoia, suicide attempts, teeth grinding, menstrual cramps or pain, bleeding between periods, coughing, bronchospasm, nosebleeds, breathing difficulty, conjunctivitis, double vision, difficulty accommodating to bright lights, eye pain, earaches, painful urination, facial swelling, frequent urination, nighttime urination, loss of urinary control, generalized swelling, a feeling of ill health, weight changes, and lymph swelling.
• Other: many other side effects affecting virtually every body system have been reported by people taking this medicine. They are too numerous to mention here but are considered infrequent or rare and affect only a small number of people.

In studies of Paroxetine before it was released in the United States, 15 percent of people taking it had to stop because of drug side effects. Be sure to report anything unusual to your doctor at once.

Paroxetine (Paxil) Drug Interactions

• Serious, sometimes fatal reactions may occur if Paroxetine and an MAO inhibitor are taken together (see Cautions and Warnings).
• People taking Warfarin may experience an increase in that drug’s effect if they start taking Paroxetine and can experience a bleeding episode. Your doctor will have to reevaluate and/or adjust your Warfarin dosage.
• Paroxetine may decrease blood levels of Digoxin by 15 percent.
• Cimetidine increases blood levels of Paroxetine by about 50 percent when the drugs are taken together.
• Phenobarbital decreases the amount of Paroxetine in the blood and increases the rate at which it is released from the body.
• When taken together, Paroxetine and Phenytoin (for seizure disorders) can affect each other. The amount of both drugs in the blood can be decreased, and both can be released from the body more quickly than normal. Your doctor will adjust your drug dosage.
• Alcoholic beverages may increase the tiredness and other nervous-system-depressant effects of Paroxetine.
• People taking L-Tryptophan and Paroxetine together may develop agitation, restlessness, and upset stomach.
• People taking Paroxetine and Procyclidine (Kemadrin, for Parkinson’s disease) experienced increased Procyclidine side effects. Your doctor may reduce your Procyclidine dosage if needed.

Food Interactions

This drug can be taken without regard to food or meals.

Usual Dose

10 to 50 mg once a day in the morning or at night.

Seniors, people with kidney or liver disease, and those taking several different medicines should remain at the lowest possible dosage for their condition.

Paroxetine (Paxil) Overdosage

In the 18 cases of Paroxetine overdose reported, all recovered completely. Symptoms of overdose are likely to be the most frequent drug side effects. There is no specific antidote for Paroxetine overdose. Any person suspected of having taken a Paroxetine overdose should be taken to a hospital emergency room for treatment at once, or you may call your local poison control center for information and directions. If you go to an emergency room, ALWAYS take the medicine bottle with you.

Paroxetine (Paxil) Special Information

Paroxetine can make you dizzy or drowsy. Take care when driving or doing other tasks that require alertness and concentration.

Do not drink alcoholic beverages if you are taking Paroxetine.

Be sure your doctor knows if you are pregnant, breastfeeding, or taking other prescription and nonprescription (over-the-counter) medications while taking Paroxetine. Notify your doctor of any unusual side effects.

If you forget a dose of Paroxetine, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten dose and continue with your regular schedule. Do not take a double dose of Paroxetine.

Paroxetine (Paxil) Special Populations

Pregnancy/Breast-feeding
There are no good studies of the effect of Paroxetine on pregnant women. Do not take this drug if you are, or might become, pregnant without first seeing your doctor and reviewing the benefits of therapy against the risk of taking Paroxetine.
Paroxetine passes into breast milk in roughly the same concentration as it enters the blood. Nursing mothers should use another feeding method if they must take this medicine.

Seniors
Older adults tend to clear this drug more slowly from their bodies, but side-effect patterns are riot affected. Any person with liver or kidney disease – problems that are more common among seniors – should receive a lower dose. Be sure to report any unusual side effects to your doctor.