Paxil (Paroxetine) - Oral

Paxil (paroxetine) is a selective serotonin reuptake inhibitor, a type of antidepressant. It is used in the treatment of depression and obsessive-compulsive disorder (OCD), panic disorder, and post-traumatic stress disorder (PTSD). 

What Is Paxil?

Paxil (paroxetine) is an SSRI antidepressant introduced in 1992 by GlaxoSmithKline. Paxil was the first formally approved SSRI for the treatment of panic disorder in the United States. Paxil is available in a generic equivalent, paroxetine, and is indicated for the treatment of:

• Panic disorder with or without agoraphobia
• Major depressive disorder
• Obsessive-compulsive disorder (OCD)
• Social anxiety disorder
• Generalized anxiety disorder
• Post-traumatic stress disorder

How to Take Paxil

Paxil (paroxetine) is usually taken once daily and may be taken with or without food. It is important to take this medication as directed by a doctor and never take it in higher amounts or more often than prescribed. 

Tablets should be swallowed whole and should not be broken, crushed, or chewed. If you are taking the liquid oral suspension, you should always shake the bottle well before measuring out your dose. Only use a spoon or oral syringe that contains the accurate amount.

Storage

Paxil should be kept in a closed container at room temperature. The medication should be kept away from direct light, moisture, heat, and freezing temperatures. Always store the medication out of the reach of children and dispose of any outdated medication.

Off-Label Uses

Paxil is sometimes prescribed off-label to treat obsessive-compulsive disorder (OCD) in children or irritable bowel syndrome. 

What Are the Side Effects of Paxil?

Like other medications, there is a risk of experiencing side effects while taking Paxil. Some side effects are more common, tend to be mild, and often gradually decrease as you become accustomed to your medication. 

Common Side Effects

Some of the common side effects associated with Paxil therapy include:

• Weakness
• Drowsiness
• Dizziness
• Nausea
• Anxiety or nervousness
• Dry mouth
• Insomnia
• Constipation or diarrhea
• Increased sweating
• Decreased libido, erectile dysfunction, ejaculatory/orgasmic inability or delay.

Some people experience a reduction in some of these side effects after being on the medication for a while. If they remain bothersome, though, you should consult with your doctor.

Severe Side Effects

You should get emergency medical attention if you experience any of the following rare but serious, side effects:

• Allergic reaction, including symptoms such as swelling of the face, lips, or tongue, or difficulty swallowing
• Seizures
• Confusion
• Hallucinations
• Fainting
• Suicidal thoughts

FDA Black Box Warning

The association of increased suicidal thoughts, especially among adolescents with SSRI treatment, has been a center of attention and controversy in recent years. In response to the concerns suggested in case studies and some research, the U.S. Food and Drug Administration (FDA) issued a statement in 2007.

The FDA proposed that makers of all antidepressant medications indicate a warning on their products about a possible increased risk of suicidal thinking and behavior in children, adolescents, and young adults.

These are not the only side effects that may be experienced with paroxetine. You should report any bothersome side effects to your doctor or other healthcare professional.

Long-Term Side Effects

There are no known problems connected to the long-term use of paroxetine. The medication is considered safe when used as prescribed and directed.

Dosage: How Much Paxil Should I Take?

Paxil, and its generic equivalent, paroxetine, are manufactured in scored tablets of 10, 20, 30, and 40 mg. It is also available in a liquid oral solution. Your doctor may begin therapy with a low dose that may be increased if your symptoms do not improve.

Starting at a low dose can also minimize some side effects because it gives your body time to adjust to the medication.

Paxil CR is a controlled-release formula that works by taking a single dose that processes in the body throughout the day. Paxil CR is manufactured in 12.5, 25, and 37.5 mg tablets.

Missed Dose

If you miss a dose, take it as soon as you remember unless it’s nearly time to take your next dose. Do not take extra Paxil to make up the missed dose.

Overdose: What Happens If I Take Too Much Paxil?

Taking too much medication may result in an overdose. Symptoms of an overdose may include:

• Diarrhea
• Drowsiness
• Dry mouth
• Headache
• Nausea 
• Vomiting
  

Serotonin Syndrome

Any SSRI antidepressant has a risk of producing a potentially life-threatening condition called serotonin syndrome. This rare condition is usually the result of an interaction of two or more drugs that affect brain serotonin levels. Even some over-the-counter supplements, such as St. John’s Wort, can result in serotonin syndrome if mixed with SSRIs.

A particularly troublesome interaction is mixing SSRIs with a class of antidepressants called monoamine oxidase inhibitors (MAOIs), which should not be taken with SSRIs. It is recommended that Paxil is avoided for two weeks before or after using an MAOI.

Precautions

Paxil is not right for everyone and people with certain medical conditions or concerns should not take Paxil. If you are taking Paxil, here are some things you should consider.

What Are Reasons I Should Not Take Paxil?

Keep in mind that this list is not all-inclusive. There can be other medical issues your doctor may need to consider.

• Pregnancy: Recent studies have linked Paxil to an increased risk of birth defects, particularly heart defects when taken during the first trimester of pregnancy. Some of these defects are mild and resolve without intervention, but some may be quite serious. It has also been suggested that exposure to SSRIs during late pregnancy may increase the risk of persistent pulmonary hypertension, a serious lung disorder, in a newborn.
• Breastfeeding: If you are nursing or are pregnant, it is best to discuss the risks and benefits of SSRI therapy with your doctor.
• NSAIDs or Aspirin: Use of Paxil with NSAIDs or aspirin may be associated with an increased risk of bleeding.
• Liver Disease: Before taking Paxil, tell your doctor if you have impaired liver function. Depending on your condition, your doctor may need to adjust your dose and perform certain tests while on Paxil therapy.
• Alcohol: Drinking alcohol with Paxil should generally be avoided.
  

What Other Medications Interact With Paxil?

Paxil may interact with other medications, including monoamine oxidase inhibitors (MAOIs). Paxil should not be taken with or within two weeks of taking MAOIs. 

Paxil can also affect how some other medications, including:

• Strattera (atomoxetine)
• Abilify (aripiprazole)
• Risperdal (risperidone) 
• Coumadin (warfarin)
• Tricyclic antidepressants
• Cardiac medications
• Medications containing ibuprofen or aspirin

Be sure to tell your doctor about all medications, including over-the-counter drugs and supplements, you are taking before beginning paroxetine.

What Medications Are Similar?

There are other SSRIs that can help boost serotonin levels in the brain. If Paxil does not work for you, talk to your doctor about trying one of the following alternatives. 

• Prozac (fluoxetine)
• Celexa (citalopram)
• Zoloft (sertraline)
• Lexapro (escitalopram)

How Can I Stay Healthy While Taking Paxil?

It may take some time for Paxil to begin working, so talk to your doctor about what you can do to manage your symptoms in the meantime. Your doctor may recommend talking to a mental health professional and utilizing psychotherapy alongside your medication.

Self-care strategies can also be beneficial, such as getting adequate sleep, engaging in regular physical activity, and getting support from friends and loved ones.

Paxil is not believed to be addictive or habit-forming. You should take Paxil exactly how it is prescribed. If you have questions or concerns, talk with your doctor.

SSRI Discontinuation Syndrome

Before discontinuing Paxil, talk with your doctor. Some people have reported withdrawal-like symptoms when decreasing or stopping SSRI therapy. It is believed that these symptoms are the result of the brain trying to stabilize serotonin levels after an abrupt change. Symptoms that may occur during discontinuation of any SSRI therapy include:

• Nausea
• Headache
• Muscle Aches
• Dizziness
• Electric shock-like sensations in the neck and head

While all of these symptoms are not believed to be dangerous, they can be quite upsetting. When discontinuing an SSRI, your doctor may give you a gradual reduction schedule to avoid these withdrawal-like symptoms.