Paxil Drug Information (Generic Paroxetine)

SSRI antidepressant

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Paxil is an antidepressant in the same family as Prozac (fluoxetine), Zoloft (sertraline), Luvox (fluvoxamine) and Celexa (citalopram). All these are selective serotonin reuptake inhibitors (SSRIs); however, Paxil is chemically unrelated to the others and to other types of antidepressants. Paxil comes in tablets and does not have to be taken with food.

Clinical trials of Paxil produced several cautions:

  • Elderly patients should take the lowest effective dose.
  • Use of Paxil in patients with impaired liver function should be undertaken with caution since the liver is involved with metabolizing the drug.
  • Caution is also indicated for patients with kidney problems.
  • A very small percentage of patients given Paxil in trials developed seizures. Treatment should be discontinued if seizures develop, and used very cautiously in patients with a history of seizures.
  • Paroxetine should be administered with caution to patients receiving oral anticoagulants. Preliminary data suggest that an interaction between paroxetine and warfarin (Coumadin) may result in increased bleeding.

Also, in 2003 the Food and Drug Administration issued a warning that Paxil should not be prescribed for the treatment of depression in children and teens. Three separate studies found that in children, Paxil is no more effective than placebo (dummy pills). Further, the UK Department of Health has issued a warning that preliminary studies indicate that this medication, named Seroxat in the UK, may increase the risk of self-injurious and suicidal behavior. If you have a child who is currently taking this medication, please discuss this with your doctor.

Note: It is essential that patients taking any version of paroxetine do not suddenly discontinue use of the drug. Any changes must be made under medical supervision. See SSRI Discontinuation Syndrome.

MAOI Antidepressant Drug Interaction with Paxil

Paroxetine should not be combined with MAO inhibitors (including Nardil, Parnate, and others) or within 2 weeks of stopping MAOI treatment. After two weeks have passed, start Paxil at a low dosage and increase gradually until an effective level is reached. Similarly, wait two weeks after stopping Paxil before starting to take any MAO inhibitor.

May Trigger Mania in People With Bipolar Disorder

During clinical testing in depressed patients, approximately 1% of patients experienced manic reactions. For bipolar patients, the incidence of mania was just over 2%. As with all antidepressants, paroxetine should be used with caution in patients with a history of mania.

Common Side Effects

The most common side effects associated with the use of paroxetine are nausea, drowsiness/sleepiness, sweating, tremor, asthenia (weakness or loss of strength), dizziness, dry mouth, insomnia and sexual dysfunction (primarily orgasmic and ejaculatory delay). About twice as many patients reported back pain on placebo as on Paxil, and half again as many experienced chest pain on placebo. This could be attributed to Paxil's anti-anxiety effects. See Paxil Side Effects for a more comprehensive list.

To avoid withdrawal syndrome (see SSRI Discontinuation Syndrome), Paxil should be tapered off rather than sharply discontinued. Avoid alcohol, as Paxil can cause drowsiness. The risk of fatal overdose is very small with Paxil. As with all SSRIs, long-term use can lead to weight gain.

Pronunciation: PAX-il, puh-ROX-eh-teen, pair-OX-eh-teen

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